Risk of death from prostate cancer can be predicted by initial PSA values

Baseline prostate-specific antigen (PSA) values may help doctors identify men at risk of death from prostate cancer, according to a study conducted by researchers at Duke University Medical Center.

According to background information provided in the press release announcing the findings, the American Urological Association recommends all men should have a baseline PSA test at age 40 years.

For the study, published in the journal Cancer (2010 Jun 29. [Epub ahead of print]), researchers used the Duke Prostate Center database to identify 4,568 men who had PSA tests during the past 20 years and who were diagnosed with prostate cancer. Patients' age and race were recorded and variables were analyzed to access any association with risk of death from prostate cancer or other causes. The median baseline PSA was 4.5, and the average follow-up period was over 9 years.

Researchers found that men with a baseline PSA of less than 4 had a very low risk of death from prostate cancer. In addition, men with a score of 4 to 9.9 were three times more likely to die from prostate cancer than those with lower scores, and those with baseline values of greater than 10 were 11 times more likely to die from prostate cancer than were men with PSAs under 2.5.

“The most important result from our study was that baseline PSA was a future predictor of death from prostate cancer,” says Ping Tang, MD, a member of the Duke Prostate Center and the department of urology at Guangzhou First Municipal People's Hospital, Guangdong, China, and the lead author of the study. “It's commonly held that men over the age of 75 don't need to bother with PSA screening any longer, but this tells us that chronological age alone may not be enough. Patients need to take into account their initial baseline value, and if it's over 4, continuous screening may be beneficial.”

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