Study Recommends Higher PSA as Risk Stratification Cutoff

In men age 50 and younger, initial PSA of 1.5 ng/ml or higher indicates increased prostate cancer risk
By Jeff Muise
HealthDay Reporter

WEDNESDAY, March 17 (HealthDay News) -- An initial prostate-specific antigen (PSA) of 1.5 ng/ml or higher may be better than the median PSA of 0.7 ng/ml for determining the risk of prostate cancer in African-American and Caucasian men age 50 and younger, according to research reported in the March issue of The Journal of Urology.

Ping Tang, Ph.D. of the Duke University Medical Center in Durham, N.C., and colleagues analyzed data on 3,530 African-American and 6,118 Caucasian men 50 years or younger with PSA levels of 4 ng/ml or less at their first PSA screening. The patients were put into groups based on initial PSA: 0.1 to 0.6, 0.7 to 1.4, 1.5 to 2.4, and 2.5 to 4.0 ng/ml. Prostate cancer incidence was monitored in nine-year follow-up, and logistic regression analysis was used to estimate prostate cancer risk for the PSA ranges.

The median PSA for both races in men 50 years or younger was 0.7 ng/ml. The researchers found that African-American and Caucasian men with an initial PSA of 1.5 to 2.4 ng/ml had 9.3-and 6.7-fold increased risks for prostate cancer, respectively. Initial PSA of 1.5 ng/ml or greater was associated with increased prostate cancer detection for each subsequent follow-up test in both races, while those with initial PSA below 1.5 ng/ml had lower rates of detection in follow-up tests.

"An initial prostate specific antigen cutoff of 1.5 ng/ml may be better than median prostate specific antigen 0.7 ng/ml to determine the risk of prostate cancer in black and white men 50 years old or younger," the authors write.

Several authors reported financial or other relationships with either Sanofi-Aventis, GlaxoSmithKline, or Astra-Zeneca.

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