Current Age and Race Adjusted Prostate Specific Antigen Threshold Values Delay Diagnosis of High Grade Prostate Cancer

Amanda Reed, Donna P. Ankerst, Bradley H Pollock, Ian M. Thompson, Dipen J. Parekh

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: Age specific prostate specific antigen ranges have been advocated to increase the predictive value of prostate specific antigen based on increases that occur with aging. We suggest that prostate specific antigen is not a dichotomous biomarker and age specific reference ranges delays the diagnosis of high grade prostate cancer in older and black American men. Materials and Methods: Using the Prostate Cancer Prevention Trial risk calculator we evaluated the impact of age on the risk of high grade prostate cancer in white and black men. We created a hypothetical population of men by standardizing risk variables, including negative family history, normal digital rectal examination and no history of negative biopsy. Results were compared in the 2 populations using 5-year age increments from ages 55 to 75 years and increasing prostate specific antigen. Results: Increasing age was associated with a higher risk of high grade prostate cancer in white and black men. The risk of high grade prostate cancer in a black man was twice that in a white man with the same prostate specific antigen at all prostate specific antigen values. Conclusions: Age specific and race specific prostate specific antigen ranges are flawed. Many patients who would not be considered for biopsy based on these prostate specific antigen ranges are at significant risk for high grade prostate cancer. The risk of high grade prostate cancer in black men is twice that in white men. Risk assessment in black men and older men is necessary to diagnose high grade prostate cancer when treatment can be effective.

Original languageEnglish (US)
Pages (from-to)1929-1932
Number of pages4
JournalJournal of Urology
Volume178
Issue number5
DOIs
StatePublished - Nov 2007
Externally publishedYes

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Prostate-Specific Antigen
Prostatic Neoplasms
Biopsy
Digital Rectal Examination
Population
Reference Values
Biomarkers

Keywords

  • African Americans
  • European continental ancestry group
  • prostate
  • prostate-specific antigen
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Current Age and Race Adjusted Prostate Specific Antigen Threshold Values Delay Diagnosis of High Grade Prostate Cancer. / Reed, Amanda; Ankerst, Donna P.; Pollock, Bradley H; Thompson, Ian M.; Parekh, Dipen J.

In: Journal of Urology, Vol. 178, No. 5, 11.2007, p. 1929-1932.

Research output: Contribution to journalArticle

Reed, Amanda ; Ankerst, Donna P. ; Pollock, Bradley H ; Thompson, Ian M. ; Parekh, Dipen J. / Current Age and Race Adjusted Prostate Specific Antigen Threshold Values Delay Diagnosis of High Grade Prostate Cancer. In: Journal of Urology. 2007 ; Vol. 178, No. 5. pp. 1929-1932.
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