1839 RISK STRATIFICATION FOR PROSTATE CANCER USING AGE-SPECIFIC PSA QUARTILES

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening II1 Apr 20101839 RISK STRATIFICATION FOR PROSTATE CANCER USING AGE-SPECIFIC PSA QUARTILES Matthew Uhlman, Leon Sun, Danielle Stackhouse, Suzanne Stewart, Cary Robertson, Thomas Polascik, David Albala, Judd Moul, and Vladimir Mouraviev Matthew UhlmanMatthew Uhlman More articles by this author , Leon SunLeon Sun More articles by this author , Danielle StackhouseDanielle Stackhouse More articles by this author , Suzanne StewartSuzanne Stewart More articles by this author , Cary RobertsonCary Robertson More articles by this author , Thomas PolascikThomas Polascik More articles by this author , David AlbalaDavid Albala More articles by this author , Judd MoulJudd Moul More articles by this author , and Vladimir MouravievVladimir Mouraviev More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1778AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES PSA remains the best early indicator for prostate cancer (PCa). Using median and quartile PSA values, we sought to identify initial PSA screening value levels in men of different ages that indicate an increased likelihood of PCa detection within ten years. METHODS A cohort of 48,128 men evaluated from 1988-2009 was retrieved from the Duke Prostate Center database, 5135 of whom had a diagnosis of PCa. Patients were stratified based upon age in 5 year increments into 9 groups. PSA quartile values were determined for each age group. Variables considered in univariate analysis included, race (African American (AA), Non-AA), PSA and PCa status. Chi-square and Kruskal-Wallis tests were used where appropriate. Binary logistic regression was used to analyze the age specific relationships between PCa, PSA median and PSA quartiles. RESULTS Patients >40 years old were found to be at a significantly increased risk of developing PCa when their initial PSA level was above the median for their age group. Patients with an age-specific PSA in the fourth quartile were uniformly at increased risk in all age groups. Over 95% of patients within the cohort, who developed PCa, did so within 10 years of their first PSA measurement. CONCLUSIONS For men of varying ages, an initial PSA above their age-specific median or in the fourth quartile effectively identifies men at risk of PCa. However, an age-specific PSA in the fourth quartile more effectively stratifies risk of PCa within ten years than age-specific medians, particularly in men between the ages of 40-65. Screening before the age of 40 is of limited utility in men without symptoms or an early family history of PCa, in line with the recent AUA PSA recommendation. Durham, NC© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e714 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Uhlman More articles by this author Leon Sun More articles by this author Danielle Stackhouse More articles by this author Suzanne Stewart More articles by this author Cary Robertson More articles by this author Thomas Polascik More articles by this author David Albala More articles by this author Judd Moul More articles by this author Vladimir Mouraviev More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...