Department of Urology, Krankenhaus Dueren gGmbH, Roonstr. 30, Düren, 52351, Germany.
It is common to start with PSA-testing at the age of 50. If patients with a PSA value > 4 ng/ml should be considered for prostate biopsy, approximately 20% of all tested men are considered for biopsy at the time of first early-detection examination.
We have screened 2,592 asymptomatic men younger than 45 years. We assessed with a short questionnaire age, BMI, concomitant diseases, last sexual intercourse and last bicycle riding. We compared this cohort with a group of 11,656 men aged 45-75 years from a nationwide prostate cancer screening trial.
In this cohort only 4 men with a PSA value > 4 ng/ml were identified and 10 with a PSA > 3 ng/ml. More than 99% of all men younger than 45 years had a PSA < 4 ng/ml. Sexual intercourse, bicycle riding or BMI had a significant but minimal influence on the PSA value.
It is reasonable to start with PSA testing at the age of 40 years. The advantage of screening younger patients is that almost no one should be considered for biopsy at the time of first early-detection examination. We identified a baseline value at which only a minimal influence was exerted by benign prostatic hypertrophy. In comparison with many current guidelines, we gained a lead time of 10 years for observation of PSA dynamics.
The importance of PSA velocity for stratification of patients at risk for development of significant prostate cancer will grow.
Boergermann C, Vom Dorp F, Becker M, Swoboda A, Ketteniß O, Rübben H. Are you the author?
Reference: Cancer Epidemiol Biomarkers Prev. 2011 Mar 29. Epub ahead of print.