Prostate-specific antigen levels in men aged 70 years and over: findings from the CHAMP study

Abstract

OBJECTIVE: To describe values of serum prostate-specific antigen (PSA) in older men without diagnosed prostate cancer, categorised by age and country of birth, and to describe self-reported prostate cancer screening. DESIGN, PARTICIPANTS AND SETTING: A cohort study (the Concord Health and Ageing in Men Project) involving a representative sample of 1434 eligible community-dwelling men with no diagnosis of prostate cancer who were aged 70 years and over and living in a defined geographic area in Sydney, with baseline data collected between 28 January 2005 and 4 June 2007. MAIN OUTCOME MEASURES: Serum PSA levels and self-reported prostate cancer screening. RESULTS: 11% of men (155) had a PSA level of >/= 6.5 ng/mL, increasing from 7.5% of men aged 70-74 years to 31.4% of men aged >/= 90 years. PSA levels varied with ethnicity, with Australian-born men (695) having the highest levels (median, 2.3 ng/mL; 5th-95th percentile, 0.4-10.1 ng/mL), followed by men born in China (n = 42; 2.1 ng/mL; 0.4-12.4 ng/mL), United Kingdom and Ireland (n = 70; 1.9 ng/mL; 0.3-8.9 ng/mL), Greece (n = 59; 1.5 ng/mL; 0.2-6.1 ng/mL), and Italy (n = 293; 1.4 ng/mL; 0.3-7.2 ng/mL). A PSA test in the previous 2 years was reported by 48% of participants, and a digital rectal examination (DRE) in the previous 2 years by 37%. CONCLUSIONS: A significant number of men aged over 70 years reported recent prostate cancer tests. The PSA level ranges reported in this cohort will help with interpreting serum PSA level findings in men aged over 70 years