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Related Experiment Videos

Age specific prostate specific antigen reference ranges: population specific

J G Borer1, J Sherman, M C Solomon

  • 1Department of Urology, State University of New York Health Science Center, Brooklyn, USA.

The Journal of Urology
|July 2, 1998
PubMed
Summary
This summary is machine-generated.

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Using age-specific prostate-specific antigen (PSA) ranges did not safely reduce prostate biopsies in men aged 60-79. A significant percentage of avoided biopsies in this group revealed undetected cancers with unfavorable histology.

Area of Science:

  • Urology
  • Oncology
  • Medical Diagnostics

Background:

  • Prostate-specific antigen (PSA) is a key biomarker for prostate cancer detection.
  • Age-specific PSA reference ranges aim to improve diagnostic accuracy by accounting for age-related variations.
  • The utility of age-specific PSA ranges in guiding prostate biopsy decisions in older men requires further investigation.

Purpose of the Study:

  • To evaluate the safety and efficacy of using age-specific PSA reference ranges to determine the necessity of prostate biopsy in men aged 60 to 79.
  • To assess the rate of missed prostate cancers, particularly those with unfavorable histology, when relying on age-specific PSA ranges.

Main Methods:

  • Retrospective review of medical records for men aged 60-79 who underwent PSA testing, digital rectal examination, and prostate biopsy.

Related Experiment Videos

  • Comparison of biopsy outcomes using the standard PSA reference range (0-4.0 ng/mL) versus four different age-specific PSA reference ranges.
  • Analysis of cancer detection rates and histological characteristics of missed cancers.

    • Main Results:

    • Out of 1,280 biopsies, 73 (5.7%) might have been avoided using age-specific ranges.
    • Fifteen of these avoided biopsies (20.5%) revealed undetected prostate cancer, with 60% exhibiting unfavorable histology.
    • Cancer detection rates were higher in Black men compared to White men, but missed cancer rates did not differ significantly by race.

    Conclusions:

    • Age-specific PSA reference ranges did not safely eliminate the need for prostate biopsy in the studied population of men aged 60-79.
    • A substantial proportion of potentially missed cancers had unfavorable histology, underscoring the risk of relying solely on age-specific PSA values.
    • The standard PSA threshold of >4.0 ng/mL remains a critical indicator for prostate biopsy in this age group with a negative digital rectal examination.