The distribution of serum prostate-specific antigen levels among American men: implications for prostate cancer prevalence and screening

Prostate. 2006 Jul 1;66(10):1044-51. doi: 10.1002/pros.20417.

Abstract

Background: The purpose of this study was to describe the distribution of serum prostate-specific antigen (PSA) among American men and to estimate the number of prevalent cases of biopsy detectable prostate cancer among men with normal serum PSA.

Methods: We analyzed data of the National Health and Nutrition Examination Survey 2001-2002 (NHANES 2001-2002) data and combined these results with published data from the Prostate Cancer Prevention Trial (PCPT).

Results: Most men in the US have a serum PSA < or = 4.0 ng/ml, and mean and median serum PSA values rise steadily with age. There are an estimated 1,607,585 (95% CI 1,370,848-1,844,322) prevalent cases of biopsy detectable prostate cancer in men aged 62-85 years with a serum PSA < or = 4 ng/ml. Among men aged 62-75 years, there are an estimated 1,252,143 (95% CI 1,054,677-1,449,609) prevalent cases, including an estimated 195,499 (95% CI 140,234-250,764) high-grade tumors.

Conclusion: A large number of prevalent cases of biopsy detectable prostate cancer exist in American men with a normal PSA.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Biopsy
  • Health Surveys
  • Humans
  • Male
  • Mass Screening*
  • Middle Aged
  • Prevalence
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / pathology
  • Reference Values
  • United States / epidemiology

Substances

  • Biomarkers
  • Prostate-Specific Antigen