Single PSA test at 45 may predict aggressive PCa

April 22, 2013

A single PSA test at 45 years of age may help predict long-term risk of developing aggressive prostate cancer, according to a recent study.

A single PSA test at 45 years of age may help predict long-term risk of developing aggressive prostate cancer, according to a recent study.

"Our findings have led to recommendations that aim to ensure men get the maximum benefit from PSA screening," said first author Andrew Vickers, PhD, of Memorial Sloan-Kettering Cancer Center, New York.

Investigators analyzed blood samples from a group of more than 21,000 men living in Malmö, Sweden, who participated in a large research study known as the Malmö Preventive Project. Although these men did not undergo regular PSA testing as part of their care, some were diagnosed and treated for prostate cancer.

Dr. Vickers and co-authors were able to test PSA levels in the blood stored from study participants and review the medical treatment records of these men to determine the aggressiveness of their cancers.

After analyzing this information, the authors concluded that most men should have their first PSA test around age 45 years, unless they have a strong family history of prostate cancer. Age 40 may be too early, and age 50 may be too late to identify a man’s risk of developing an aggressive cancer, Dr. Vickers explained.

This initial test can be used to place men on one of two screening paths:

  • Men with a PSA level of 1.0 ng/mL or higher at age 45 are at an above-average risk of developing life-threatening prostate cancer. These men should be regularly screened for changes in PSA level until around age 70, with repeat PSA testing.

  • Men with a PSA level at or below 1.0 ng/mL should have two additional PSA tests, one in their early 50s and another at 60 years of age to ensure that their PSA levels remain low. Testing is not necessary after age 60 because any cancer that develops will likely be slow growing and not life threatening, according to the researchers.

 

"The big take-home message is that a single PSA test at age 45 can be used to predict a man’s long-term risk of developing an aggressive prostate cancer," Dr. Vickers said.

Study results were published online in the British Medical Journal (April 16, 2013).

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