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Serum prostate‐specific antigen in a community‐based population of healthy Japanese men: lower values than for similarly aged white men
Author(s) -
Oesterling J.E.,
Kumamoto Y.,
Tsukamoto T.,
Girman C.J.,
Guess H.A.,
Masumori N.,
Jacobsen S.J.,
Lieber M.M.
Publication year - 1995
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1995.tb07347.x
Subject(s) - white (mutation) , prostate specific antigen , medicine , demography , gerontology , prostate cancer , physiology , biology , genetics , cancer , gene , sociology
Objective To determine whether the age‐specific reference ranges for serum prostate‐specific antigen (PSA) concentration generated for white men are applicable to other races. Patients and methods Three‐hundred and thirty‐five healthy lapanese men, aged 40–79 years, residing in the small fishing village of Shimamaki‐mura, Japan, agreed to enter this prospective, community‐based study. All underwent a detailed clinical evaluation that included a serum PSA determination, a digital rectal examination and a transrectal ultrasound. Two‐hundred and eighty‐six (85%) completed the prostatic evaluation and had no evidence of prostate cancer by any one of the three diagnostic tests; these men formed the study population on which all analyses were performed. Results The serum PSA concentration correlated directly with patient age (r = 0.33; P<0.001) and prostatic volume ( r =0.57; P<0.001). PSA density (PSAD) also was directly proportional to age ( r = 0.30; P<0.001). Adjusting for age, the serum PSA concentration was lower for Japanese men than for white men ( P <0.001). Thus, the recommended age‐specific reference ranges (95th percentile) for serum PSA for Japanese were lower as well: 0.0–2.0 ng/mL for 40–49 years; 0.0–3.0 ng/mL for 50–59 years; 0.0–4.0 ng/mL for 60–69 years; and 0.0–5.0 ng/mL for 70–79 years. Based on transrectal ultrasound‐volume determinations, the lower serum PSA concentrations in Japanese men are due in large part to their smaller prostate glands as compared with white men ( P <0.001). Conclusions These findings confirm the earlier observations that serum PSA, prostatic volume and PSAD are age‐dependent. However, because of physiological differences among the two races, partly due to the size of the prostate gland, the age‐specific reference ranges for serum PSA are lower for Japanese men than for white men. Because of these racial differences, it is now crucial to conduct a similar investigation among black men.