Age-Specific Reference Ranges for Prostate-Specific Antigen

To the Editor. —In their recent article in JAMA , Oesterling et al 1 describe a randomly chosen population of 537 asymptomatic men between 40 and 79 years of age who participated in a clinical examination including prostate-specific antigen (PSA), digital rectal examination (DRE), and transrectal ultrasonography (TRUS), and TRUS-guided biopsies on indication. Only 88% of these men formed the study population, since 61 men (11%) did not complete the investigations and five men (1%) were found to have prostatic carcinoma. The data of Oesterling et al are compatible with those of the Rotterdam feasibility study of screening for prostate carcinoma in 548 men between 55 and 75 years of age, published by Kirkels et al. 2 Although the correlation of serum PSA concentration with age was only. 21 in the study by Kirkels et al, the correlation of prostatic volume with age and PSA concentration was the same as in the