Using age-referenced prostate-specific antigen percentile to predict survival outcomes in screened Taiwanese men - Abstract

The survival outcomes of Asian men with elevated prostate-specific antigen (PSA) levels at screening are largely unknown.

We present the clinical outcomes of Taiwanese men based on their screening PSA levels. Between 1994 and 2006, 27,761 men aged over 40 years underwent PSA screening in a self-funded health examination. The clinical database was linked with the national cancer and death registry databases to generate prostate cancer incidence, prostate cancer mortality (PCM), and overall mortality (OM). Participants were followed until the end of 2009. Survival analyses were performed for the participants' outcomes, and were stratified by five 10-year age strata (age 40-< 50, 50-< 60, 60-< 70, 70-< 80 and ò80), and six age-referenced PSA percentile groups, divided by the 50th , 75th , 90th , 95th , and 99th percentile of PSA values for each 10-year age stratum. The median age of the 27,761 men was 54.7 years. The median PSA level at cancer diagnosis was 4.46 ng/ml. Specifically, the PSA levels for the five 10-year age strata in order of respectively increasing ages were 1.93, 3.50, 4.10, 6.94 and 12.4 ng/ml. After a median follow-up of 8.4 years, 2,463 men died and 337 were diagnosed with prostate cancer. Among the 337 patients, 29 (8.6%) died of prostate cancer. The prostate cancer incidence, PCM, and OM rates were higher in men with higher age-referenced PSA percentile values. The 10-year PCM rate for men with ò the 99th age-referenced PSA percentile was 3.9%, which was significantly higher than the rate of ? 0.5% in the lower percentile groups.

Written by:
Chen CH, Yao HH, Huang SW, Chuang CK, Hsu HS, Wang CJ, Pu YS.   Are you the author?
Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.

Reference: Int J Cancer. 2012 Sep 14. Epub ahead of print.
doi: 10.1002/ijc.27842

PubMed Abstract
PMID: 22987331 Prostate Cancer Section