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 undergoinga routine health examination in our hospital were recruited into the study. Allmen received a digital rectal examination (DRE) and serum PSA determinationand some received a transrectal ultrasound (TRUS). Men with normalDRE findings, and PSA < 4.0 ng/ml, PSA between 4.0 ng/ml and 20 ng/mlwith a negative TRUS or abnormal TRUS findings (hypoechoic lesion orothers) with a negative biopsy were defined as clinically free of prostate cancer.Results: A total of 7803 participants without clinical evidence of prostate cancer wereincluded in the study. The median PSA value (95th percentile range) was0.896 ng/ml (3.329) for men 50-59 years old; 1.151 ng/ml (5.114) for men60-69 years old; 1.623 ng/ml (6.237) for men 70-79 years old and 1.754ng/ml (6.613) for men older then 80 years. The serum PSA values correlatedwith age (r = 0.3078, p < 0.001). There were small changes in the medianand 95th percentile PSA values in men younger than 50 years old, but largeincreases 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 screeningtests in Taiwanese men.