Adult urology: CME articleLow levels of prostate-specific antigen predict long-term risk of prostate cancer: results from the Baltimore Longitudinal Study of Aging☆
Section snippets
Study population
The Baltimore Longitudinal Study of Aging (BLSA) is an ongoing, long-term prospective study of aging conducted by the National Institute on Aging (Bethesda, Md), which has been previously described.7 Since the inception of the BLSA in 1958, a total of 1665 men and 1019 women have participated in the study for varying lengths of time. The participants in the study return for follow-up visits at approximately 2-year intervals.
Beginning in 1991, prostate cancer diagnoses were confirmed by
RR estimates
The subjects were divided into four evenly sized groups on the basis of the PSA quartiles (Table II). The PSA levels that defined the groups were 0.30, 0.59, and 0.90 ng/mL for men aged 40 to 49.9 and 0.40, 0.70, and 1.4 ng/mL for men aged 50 to 59.9. For men 40 to 49.9 years old with PSA levels of 0.6 to 0.9 ng/mL, the RR of prostate cancer was 7.9-fold (range 1.7 to 35.5) greater and was significantly different statistically from those men with PSA levels of 0.3 ng/mL or less. The RR was
Comment
We have shown, for the first time, the long-term risk of development of prostate cancer in young men during two to three decades as a function of the PSA level. The increased risk of prostate cancer in men aged 40 to 49.9 and 50 to 59.9 with the highest (albeit “normal”) baseline PSA levels becomes evident after 10 to 15 years of follow-up, and was surprisingly similar when the PSA levels were in either of the two quartiles above the median (Table II). Thus, young men with PSA levels around 1.0
References (16)
- et al.
Decline in prostate cancer mortality from 1980 to 1997, and an update on incidence trends in Olmsted County, Minnesota
J Urol
(1999) - et al.
Downward trend in prostate cancer mortality in Quebec and Canada
J Urol
(1999) - et al.
Hereditary prostate cancerepidemiologic and clinical features
J Urol
(1993) - et al.
Familial predisposition to breast cancer in a British populationimplications for prevention
Eur J Cancer
(2000) - et al.
Stem cell features of benign and malignant prostate epithelial cells
J Urol
(1998) - et al.
Prostate cancer prevention trials in the USA
Eur J Cancer
(2000) - et al.
Cancer surveillance seriesinterpreting trends in prostate cancer. Part I. Evidence of the effects of screening in recent prostate cancer incidence, mortality and survival rates
J Natl Cancer Inst
(1999) - et al.
A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer
JAMA
(1995)
Cited by (165)
Baseline Prostate-specific Antigen Level in Midlife and Aggressive Prostate Cancer in Black Men(Figure presented.)
2019, European UrologyCitation Excerpt :Another nested case-control study [11] in a different California population found that PSA at a median age of 34 yr was associated with increased risk of total and aggressive PCa over several decades, though loss to follow-up was high and outcome ascertainment somewhat incomplete [11]. Our results are in line with those studies as well as with studies of the longer-term predictive value of baseline PSA among primarily white men in the USA [2,9–11,13] and Sweden [15,16]. We [2] and others have found substantially increased risk of PCa metastasis or death over 20–30 yr of follow-up for men with higher PSA at age 35–55 yr.
Prostate Cancer Screening
2018, Medical Clinics of North AmericaPopulation Screening for Prostate Cancer and Early Detection
2016, Prostate Cancer: Science and Clinical Practice: Second EditionTotal and Free PSA, PCA3, PSA Density and Velocity
2016, Prostate Cancer: Science and Clinical Practice: Second Edition
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This study was supported by Prostate Spore NCI-CA58236, National Institute on Aging Intramural Research Program.