Age-related reference levels of serum prostate-specific antigen among Taiwanese men without clinical evidence of prostate cancer.

BACKGROUND To determine the normal distribution of serum prostate-specific antigen (PSA) levels in Taiwanese men without clinical evidence of prostate cancer. METHODS Between August 2006 and October 2007, healthy Taiwanese men undergoing a routine health examination in our hospital were recruited into the study. All men received a digital rectal examination (DRE) and serum PSA determination and some received a transrectal ultrasound (TRUS). Men with normal DRE findings, and PSA < 4.0 ng/ml, PSA between 4.0 ng/ml and 20 ng/ml with a negative TRUS or abnormal TRUS findings (hypoechoic lesion or others) with a negative biopsy were defined as clinically free of prostate cancer. RESULTS A total of 7803 participants without clinical evidence of prostate cancer were included in the study. The median PSA value (95th percentile range) was 0.896 ng/ml (3.329) for men 50-59 years old; 1.151 ng/ml (5.114) for men 60-69 years old; 1.623 ng/ml (6.237) for men 70-79 years old and 1.754 ng/ml (6.613) for men older then 80 years. The serum PSA values correlated with age (r = 0.3078, p < 0.001). There were small changes in the median and 95th percentile PSA values in men younger than 50 years old, but large increases in those older than 50 years. CONCLUSIONS These findings confirm that the serum PSA is directly correlated with age, and offer more efficient PSA reference values for prostate cancer screening tests in Taiwanese men.