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• W2038348043 abstract "No AccessJournal of UrologyClinical Urology: Original Articles1 Feb 1998AGE SPECIFIC PROSTATE SPECIFIC ANTIGEN REFERENCE RANGES: POPULATION SPECIFIC Joseph G. Borer, Joel Sherman, Michael C. Solomon, Marc W. Plawker, and Richard J. Macchia Joseph G. BorerJoseph G. Borer More articles by this author , Joel ShermanJoel Sherman More articles by this author , Michael C. SolomonMichael C. Solomon More articles by this author , Marc W. PlawkerMarc W. Plawker More articles by this author , and Richard J. MacchiaRichard J. Macchia More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63945-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined whether 60 to 79-year-old men with a negative digital rectal examination and a serum prostate specific antigen (PSA) within age specific PSA reference ranges could safely forgo prostate biopsy. Materials and Methods: We reviewed the medical records of all 60 to 79-year-old men at the Brooklyn Veterans Administration Medical Center who had a PSA assay, digital rectal examination and subsequent prostate biopsy for an abnormal rectal examination and/or PSA greater than 4.0 ng./ml. from January 1991 through August 1995. We compared our results using the standard reference range of 0 to 4.0 ng./ml. with those obtained had we used any of 4 different age specific PSA reference ranges. Results: We performed 1,280 prostate biopsies in 1,046 men with available PSA and digital rectal examination data. Using age specific PSA reference ranges 73 of 1,280 biopsies (5.7%) would have been avoided. Of those 73 avoided biopsies 15 (20.5%) had cancer that would have gone undetected and 9 of 15 (60%) undetected cancers had unfavorable histology. Results were not statistically significantly different among the 4 age specific PSA reference ranges. Regarding race, cancer detection rates were significantly higher for black compared with white men but there was no statistically significant difference for missed cancers or missed cancers with unfavorable histology. Conclusions: In contrast to previous reports of unfavorable histological characteristics in only 5% of missed cancers using age specific PSA reference ranges, 60% of missed cancers in our patients exhibited unfavorable histology. We conclude that age specific PSA reference ranges did not safely eliminate the need for prostate biopsy in our study population. In 60 to 79-year-old men with a negative digital rectal examination we continue to use PSA greater than 4.0 ng./ml. as an indication for prostate biopsy. References 1 : Serum prostate-specific antigen in a community-based population of healthy men: establishment of age-specific reference ranges.. J.A.M.A.1993; 270: 860. Google Scholar 2 : Prostate specific antigen levels in men older than 50 years without clinical evidence of prostatic carcinoma.. J. Urol.1993; 150: 1837. Link, Google Scholar 3 : Relationship between prostate specific antigen, prostate volume and age in the benign prostate.. Brit. J. Urol.1993; 71: 445. Google Scholar 4 : Age specific reference ranges for serum prostate-specific antigen.. Urology.1995; 46: 54. Google Scholar 5 : Prostate cancer awareness week demonstrates continued value to early detection strategies.. J. 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Google Scholar 11 : Clinical significance of prostate specific antigen age-specific reference ranges.. J. Urol.1995; 153: 465A. part 2, abstract 945. Google Scholar 12 : Normal range prostate-specific antigen versus age-specific prostate-specific antigen in screening prostate adenocarcinoma.. Urology.1995; 46: 200. Google Scholar 13 : Comparison of different prostate-specific antigen cutpoints for early detection of prostate cancer: results of a large screening study.. Urology.1995; 46: 662. Google Scholar 14 : The use of age-specific reference ranges for serum prostate specific antigen in men 60 years old or older.. J. Urol.1995; 153: 1160. Link, Google Scholar 15 : Standard versus age-specific prostate specific antigen reference ranges among men with clinically localized prostate cancer: a pathological analysis.. J. Urol.1996; 155: 1336. Link, Google Scholar 16 : Role of prostate-specific antigen density after applying age-specific prostate-specific antigen reference ranges.. Urology.1995; 45: 972. Google Scholar 17 : Pathologic and clinical findings to predict tumor extent of nonpalpable (Stage T1c) prostate cancer.. J.A.M.A.1994; 271: 368. Google Scholar 18 : Stat Xact: Statistical Software for Exact Nonparametric Inference.. Cambridge, Massachusetts: Cytel Software Corp.1991. Google Scholar 19 : Using prostate-specific antigen to eliminate unnecessary diagnostic tests: significant worldwide economic implications.. Urology.1995; 46: 26. Google Scholar 20 : Age-specific reference ranges for serum prostate-specific antigen in black men.. New Engl. J. Med.1996; 355: 304. Google Scholar 21 : Significance of different molecular forms of serum PSA: the free, noncomplexed form of PSA versus that complexed to alpha-1-antichymotrypsin.. Urol. Clin. N. Amer.1993; 20: 681. Google Scholar 22 : Impact of tumor doubling time (DT) and age-based reference values for PSA on prostate cancer (PCa) screening outcome.. J. Urol.1995; 153: 505A. part 2, abstract 1106. Google Scholar 23 : The definition and preoperative prediction of clinically insignificant prostate cancer.. J.A.M.A.1996; 275: 288. Google Scholar Department of Urology, State University of New York Health Science Center, Brooklyn, New York.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKARAZANASHVILI G and ABRAHAMSSON P (2018) Prostate Specific Antigen and Human Glandular Kallikrein 2 in Early Detection of Prostate CancerJournal of Urology, VOL. 169, NO. 2, (445-457), Online publication date: 1-Feb-2003. Volume 159Issue 2February 1998Page: 444-448 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information Joseph G. Borer More articles by this author Joel Sherman More articles by this author Michael C. Solomon More articles by this author Marc W. Plawker More articles by this author Richard J. Macchia More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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