Age-specific reference ranges for Serum Prostate specific Antigen in South Indian Men.

INTRODUCTION :Prostate-specific antigen (PSA) is the most clinically usefultumour marker available today for the diagnosis and managementof prostate cancer; unlike other tumor markers prostate specificantigen is not cancer specific. Overlapping serum PSAconcentrations between benign prostatic hyperplasia andprostatic adenocarcinoma limit the effectiveness of serum PSA indetecting early prostate cancer.Several concepts have been devised to optimize thediagnostic value of serum PSA. Various PSA relation markershave been advocated for the differentiation between benignprostate hypertrophy and carcinoma in so called "gray zone"level of total PSA.Age specific PSA reference ranges provide greatersensitivity for cancer detection in younger men at the expense ofa greater negative biopsy rate. In older men unnecessary biopsiescould be spared.AIM :To determine age-specific reference ranges for serum prostate-specificantigen (PSA) concentration in South Indian men.MATERIALS AND METHODS :This study analyzed the PSA value of 117 subjects with outlower urinary tract symptoms during the period October 2003 toSeptember 2005 at Government General Hospital, Chennai. Inclusion criteria: 1. Individuals attending Urology Clinics for minor illness. 2. Normal healthy volunteers. Exclusion criteria: 1. Subjects with history of lower urinary tract symptoms2. Subjects with history of recent urethral instrumentation3. Subjects with history of recent catheterization4. Patients with history of Prostatitis. Statistical analysis by Student‘t’ test. Confidence intervalsmean, minimum and maximum values were calculated for eachdecade of age group. Confidence interval high represents 95thpercentile value in a given group.CONCLUSION : The serum PSA concentration directly correlates with thepatient’s age. Thus, rather than relying on a singlereference range for men of all age groups, it is moreappropriate to have age-specific reference ranges. Age-specific reference ranges have the potential to makeserum PSA a more discriminating tumor marker fordetecting clinically significant cancers in older men and tofind more potentially curable cancers in younger men. Age and race specific reference range will help indeveloping specific algorithm for different population todetect adenocarcinoma of the prostate at an earlier stage.