Abstract
Context: Prostate cancer screening is highly controversial, including the age to begin prostate-specific antigen (PSA) testing. Several studies have evaluated the usefulness of baseline PSA measurements at a young age. Objective: Review the literature on baseline PSA testing at a young age (≤60 yr) for the prediction of prostate cancer risk and prognosis. Evidence acquisition: PubMed was searched for English-language publications on baseline PSA and prostate cancer for the period ending April 2011. Evidence synthesis: In most published series, median PSA levels in the general male population range from approximately 0.4 to 0.7 ng/ml in men in their 40s and from approximately 0.7 to 1.0 ng/ml in men in their 50s. Evidence from both nonscreening and screening populations has demonstrated the predictive value of a single baseline PSA measurement for prostate cancer risk assessment. Specifically, men with baseline PSA levels above the age-group-specific median have a greater risk of prostate cancer diagnosis during the next 20-25 yr. Additional studies confirmed that higher baseline PSA levels at a young age are also associated with a greater risk of aggressive disease, metastasis, and disease-specific mortality many years later. Conclusions: Baseline PSA measurements at a young age are significant predictors of later prostate cancer diagnosis and disease-specific outcomes. Thus baseline PSA testing may be used for risk stratification and to guide screening protocols.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | European urology |
| Volume | 61 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2012 |
Funding
Currently, a minority of men in their 40s undergoes PSA testing, and several professional organizations do not recommend considering PSA screening until age 50. However, baseline PSA measurements at a young age are stronger predictors of prostate cancer risk than race and family history. Baseline PSA measurements at a young age are robust predictors of aggressive prostate cancer, metastasis, and disease-specific mortality many years later. Thus baseline PSA testing might be useful for risk stratification and to individualize screening protocols. Author contributions : Stacy Loeb had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design : Loeb, Carter, Catalona, Moul, Schroder. Acquisition of data: Loeb, Moul, Schroder. Analysis and interpretation of data : Loeb, Carter, Catalona, Moul, Schroder. Drafting of the manuscript : Loeb, Schroder. Critical revision of the manuscript for important intellectual content : Loeb, Carter, Catalona, Moul, Schroder. Statistical analysis : None. Obtaining funding : None. Administrative, technical, or material support : Loeb. Supervision : Carter, Catalona, Moul, Schroder. Other (specify): None. Financial disclosures : I certify that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/ affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: William J. Catalona receives research support from Beckman Coulter Inc., deCODE Genetics Inc., and OHMX. Judd Moul is a consultant for IRIS, which he considers unrelated. Funding/Support and role of the sponsor : None.
Keywords
- Baseline
- Prognosis
- Prostate-specific antigen
- Screening
- Young age
ASJC Scopus subject areas
- Urology
