BERKELEY, CA (UroToday.com) - PSA velocity (PSAV) increases in men with higher total PSA levels according to a report from Dr. Xiaoying Yu, Dr. William J. Catalona, and colleagues that appears in the April 2007 issue of the Journal of Urology.

The study evaluated 3 groups using Dr. Catalona's PSA screening database. The first group consisted of 13, 276 men whom had serial PSA measurements from which PSAV was calculated. Men with a diagnosis of prostate cancer (CaP) had PSAV calculated for the year prior to diagnosis, and all other men had PSAV calculated from the PSA screening database. The second group included 1,851 men with a normal DRE who underwent prostate biopsy for an increased PSA level (above 4.0ng/ml prior to May 1995 and above 2.5ng/ml after that). The third group consisted of 894 men with CaP from whom a PSAV could be calculated.

In the all screened group of 13,276 men, the mean age was 65 years and the mean PSA in this cohort was 2.0ng/ml. The percentage of men with a PSA <2.5, 2.6-4.0, 4.1-10.0 and >10ng/ml were 75%, 13%, 10%, and 1%, respectively. The all biopsied group consisted of 1,851 men with a non suspicious DRE who had at least 1 biopsy. The mean age was 65 years and the mean PSA was 4.2ng/ml. The percentage of men with a PSA <2.5, 2.6-4.0, 4.1-10.0 and >10ng/ml were 1%, 57%, 40%, and 2%, respectively. There were 16% of men in this group with a PSAV greater than 3ng/ml. The all CaP group had a mean age of 66 years and a mean PSA of 4.3ng/ml. The percentage of men with a PSA <2.5, 2.6-4.0, 4.1-10.0 and >10ng/ml were 13%, 44%, 41%, and 3%, respectively.

In all three groups, as the total PSA level increased, the median and mean PSAV also significantly increased. The number of men presenting with a PSAV >2ng/ml/yr was significantly greater among men with higher total PSA levels. The overall correlation coefficient between PSA and PSAV was 0.68, 0.70, and 0.64 in groups 1, 2, and 3, respectively. The Pearson correlation coefficient between PSA and PSAV was 0.29 in men with a PSA of <4ng/ml and 0.66in men with a PSA >4.0ng/ml. In men with CaP, there was a significant correlation between PSA and PSAV in all age groups. Thus, the correlation between PSA and PSAV slightly increased with age and remained strongly significant for all age ranges the authors conclude.

Yu X, Loeb S, Roehl KA, Han M, Catalona WJ

J Urol 2007; 177:1298-1302

UroToday.com Prostate Cancer Section

Written by Christopher P. Evans, MD, a Contributing Editor with UroToday.

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