Distribution of prostate specific antigen (PSA) and percentage free PSA in a contemporary screening cohort with no evidence of prostate cancer

Felix K H Chun, Georg C. Hutterer, Paul Perrotte, Andrea Gallina, Luc Valiquette, Francois Benard, Michael McCormack, Alberto Briganti, Constantin Ionescu, Claudio Jeldres, Jean Pierre Guay, Fred Saad, Pierre I. Karakiewicz

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To explore the distribution of total prostate specific antigen (PSA) and percentage free/total PSA (%f/tPSA) in healthy volunteers with no clinical evidence of prostate cancer, who participated in prostate cancer screening. SUBJECTS AND METHODS: PSA and %f/tPSA values from 2323 men, who participated in one of three annual prostate cancer screening events between 2004 and 2006, were tabulated according to age strata of 40-49, 50-59, 60-69 and 70-79 years. Local regression smoothing plots provided a graphical display of the relation between age and PSA or %f/tPSA, respectively. All PSA and %f/tPSA analyses were repeated for each age category after excluding, respectively, the top and the bottom 10% of PSA and %f/tPSA values. RESULTS: Within the entire cohort, the median PSA level was 1.0 ng/mL and the median %f/tPSA was 25%. According to the age categories the PSA level and %f/tPSA medians within the entire cohort were, respectively, 0.7, 0.9, 1.3, 1.8 ng/mL and 28.0, 26.0, 24.0 and 25.0%. Of the 2323 men, 438 (18.9%) had a PSA level of >2.5 ng/mL and 1172 (50.5%) had a %f/tPSA of ≤ 25%. When either a PSA level of >2.5 ng/mL or a %f/tPSA of ≤ 25% were considered, 1235 (53.2%) had one or two abnormal values. Finally, if either a PSA level of >2.5 ng/mL or %f/tPSA of ≤ 15% was used, 617 (26.6%) were considered abnormal. CONCLUSION: Half of men with no clinical evidence of prostate cancer should have PSA levels of 25%. A PSA level threshold of 2.5 ng/mL would require a biopsy in 20% of men and a %f/tPSA threshold of ≤ 25% in half of the men. Alternatively, a %f/tPSA threshold of ≤ 15% would decrease the probability to 15%.

Original languageEnglish
Pages (from-to)37-41
Number of pages5
JournalBJU International
Volume100
Issue number1
DOIs
Publication statusPublished - Jul 2007

Keywords

  • % free PSA
  • Biopsy
  • Detection
  • Prostate cancer
  • PSA
  • Screening

ASJC Scopus subject areas

  • Urology

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