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Prostate specific‐antigen distribution in asymptomatic Canadian men with no clinical evidence of prostate cancer
Author(s) -
CHUN FELIX K.H.,
PERROTTE PAUL,
BRIGANTI ALBERTO,
BENAYOUN SERGE,
LEBEAU THIERRY,
RAMIREZ ALVARO,
LEWINSHTEIN DANIEL J.,
VALIQUETTE LUC,
GUAY JEANPIERRE,
KARAKIEWICZ PIERRE I.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06193.x
Subject(s) - medicine , prostate cancer , asymptomatic , rectal examination , prostate specific antigen , urology , prostate , gynecology , prostate biopsy , transrectal ultrasonography , cancer
OBJECTIVE To examine prostate specific‐antigen (PSA) levels and percentage free/total PSA (f/tPSA) distributions as well as digital rectal examination (DRE) profiles in asymptomatic Canadian men with no established prostate cancer diagnosis, as recent data indicate that a man’s risk of developing prostate cancer is higher if his baseline PSA level is above the median for his age group. SUBJECTS AND METHODS We used data obtained during an early prostate cancer‐detection event. An invitation to an onsite DRE, PSA level and f/tPSA assessment was accepted by 313 men. Serum PSA level and f/tPSA were measured before the DRE. A suspicious DRE and/or PSA level of ≥ 2.5 ng/mL or f/tPSA of ≤ 15% represented indications for a systematic 12‐core ultrasonography‐guided prostate biopsy. RESULTS Of all the 313 men, most (235, 75%) had PSA levels of 0.01–1.53 ng/mL and an f/tPSA of >15% (285, 91.1%). The median (range) PSA level was 0.8 (0–34.2) ng/mL and f/tPSA was 27.4 (6.7–100)%. Age‐specific median PSA levels and f/tPSA were, respectively, 0.7, 0.9, 1.0, 1.5 ng/mL and 31%, 27%, 26%, 25% for men aged 40–49, 50–59, 60–69 and 70–79 years. A suspicious DRE was recorded in 55 (17.6%) men, with eight (8.8%), 26 (20.0%), 14 (20.6%), and seven (28.9%) having suspicious DRE findings according to above age categories. Overall, seven (2.2%) prostate cancers were detected. CONCLUSION The median age‐specific baseline PSA levels and f/tPSA represent valuable indicators of prostate cancer risk. The population‐specific baseline median PSA level should not be >1.0 ng/mL and the baseline f/tPSA should be >30%. Men with values outside of these ranges should be considered at greater risk of prostate cancer.