Optimal baseline prostate-specific antigen level to distinguish the risk of prostate cancer in healthy men between 40 and 69 years of age

Abstract

Objectives: To evaluated the optimal baseline PSA level at different ages to determine the risk of CaP.Patients and Methods: We analyzed a large cohort of 6,651 Korean men in age 40-69, The serum PSA levels for the men were measured at one institute from 2000 to 2004 and were determined to be between 0-4 ng/ml. Patients were divided into 4 groups of 25th-percentile intervals, based on initial PSA level. Of these, the group which has a increased risk were selected, and the optimal value was determined by the maximal AUC from the receiver-operating characteristic curve (ROC) within the selected group. The risk of CaP diagnosis was evaluated by Cox regression.Results: The mean follow-up period was 8.3 years. The optimal PSA values to distinguish the risk of CaP were 2.0ng/ml for 50- to 59-year-olds and 1.5ng/ml for 60- to 69-year-olds. Patients with a baseline PSA level greater than the optimal value had a 33.15 and 24.41-fold increase in the age-adjusted prostate cancer risk, respectively.Conclusions: Baseline measurements of PSA should begin at the age of 50. Furthermore, the optimal cutoff values depend on the age.Impact: Optimal PSA cutoff value to distinguish the risk of prostate cancer was different depending on the incidence of prostate cancer of ages.