Impact of age on total and complexed prostate-specific antigen cutoffs in a contemporary referral series of men with prostate cancer

• Published in: Urology (Ridgewood, N.J.) N.J.), 2002-10, Vol.60 (4), p.47-52
• Main Authors: Veltri, Robert W, Miller, M.Craig, O’dowd, Gerard J, Partin, Alan W
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Biopsy; Humans; Male; Middle Aged; Prospective Studies; Prostate - pathology; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - pathology; Reference Values; Sensitivity and Specificity
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(02)01695-3

Age-specific prostate-specific antigen (PSA) cutoffs were previously suggested and were found to miss significant cancers in older men. We assessed the influence of an age-adjusted PSA cutoff to optimize the diagnostic performance (sensitivity and specificity) of complexed PSA (cPSA) and total PSA (tPSA) in the differentiation of benign disease from prostate cancer using a contemporary referral patient cohort. The cPSA and tPSA values were determined using the Bayer Immuno 1 system. The diagnostic utility of tPSA and cPSA was assessed using a diverse contemporary test population consisting of sera prospectively collected between June 1999 and October 2000 from 3597 men who recently underwent a systematic biopsy by urologists in clinical practices throughout the United States. This contemporary patient sample had biopsy diagnoses of either no evidence of malignancy (NEM; n = 2189) or prostate cancer (n = 1408). All serum samples had tPSA values between 2.0 and 20.0 ng/mL. The mean tPSAs (ng/mL) for the NEM and prostate cancer groups were 7.1 ± 3.2 and 7.3 ± 3.3, respectively ( P = 0.026). The mean cPSAs (ng/mL) for the NEM and prostate cancer groups were 5.6 ± 2.7 and 6.0 ± 2.9, respectively ( P