Serum prostate-specific antigen in healthy Chinese men: establishment of age-specific reference ranges

The purpose of this study is to establish the normal range of serum prostate-specific antigen (PSA) and to evaluate the influence of age in a population of healthy Chinese men. Subjects with PSA concentration of less than 4.0 ng/ml and normal digital rectal examination (DRE) or PSA level greater than 4.0 ng/ml and/or abnormal results of DRE with negative biopsy were defined as clinically free of prostate cancer. A total of 1008 men aged between 21 and 80 years of age fulfilled the criteria of establishing the upper limits for PSA levels. The population was grouped by age decades. The 95th percentile was determined as the upper limit of normal (reference range) for each 10-year age group for the serum PSA concentration. Our data showed that the upper limit of normal (95th percentile) for the serum PSA concentration increases with age. It is 1.92 ng/ml for men 21 to 30 years of age. 1.85 ng/ml for men 31 to 40 years of age, 2.59 ng/ml for men 41 to 50 years of age, 3.31 ng/ml for men 51 to 60 years of age, 5.03 ng/ml for men 61 to 70 years of age and 5.73 ng/ml for men 71 to 80 years of age. In conclusion, the serum PSA concentration is directly correlated with patient age. The age-specific reference ranges should be established so as to increase diagnostic specificity in older men and increase diagnostic sensitivity in younger men and then the PSA assay can become more efficient as a screening test for prostatic cancer.