Ethnicity Is an Independent Determinant of Age-Specific PSA Level: Findings from a Multiethnic Asian Setting

Abstract

ObjectivesTo study the baseline PSA profile and determine the factors influencing the PSA levels within a multiethnic Asian setting.Materials and MethodsWe conducted a cross-sectional study of 1054 men with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The serum PSA concentration of each subject was assayed. Potential factors associated with PSA level including age, ethnicity, height, weight, family history of prostate cancer, lower urinary tract voiding symptoms (LUTS), prostate volume and digital rectal examination (DRE) were evaluated using univariable and multivariable analysis.ResultsThere were 38 men (3.6%) found to have a PSA level above 4 ng/ml and 1016 (96.4%) with a healthy PSA (≤4 ng/ml). The median PSA level of Malay, Chinese and Indian men was 1.00 ng/ml, 1.16 ng/ml and 0.83 ng/ml, respectively. Indians had a relatively lower median PSA level and prostate volume than Malays and Chinese, who shared a comparable median PSA value across all 10-years age groups. The PSA density was fairly similar amongst all ethnicities. Further analysis showed that ethnicity, weight and prostate volume were independent factors associated with age specific PSA level in the multivariable analysis (p<0.05).ConclusionThese findings support the concept that the baseline PSA level varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity may also need to be taken into account when investigating serum PSA concentrations in the multiethnic Asian population.

Cardiovascular Risk Factors and Ethnicity Are Independent Factors Associated with Lower Urinary Tract Symptoms

“…There were eight participating hospitals in which five of them serve as tertiary referral centers for urology services in the region. Detailed methods of subject recruitment and data collection have been previously described [ 16 ].…”

“…Each participant completed the interviews particularly the IPSS questionnaire and had no history of prostate cancer, previous history of prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The baseline serum prostate specific antigen (PSA) level was measured in all subjects using total PSA assays described in [ 16 ]. Those of PSA > 4 ng/ml who refused for TRUS-guided prostate biopsy or confirmed with prostate cancer were excluded from the study.…”

The age-specific reference intervals for tPSA, fPSA, and %fPSA in healthy Han ethnic male

“…PSA is prostate specific but not PC specific. It is expressed not only in patients with PC but also in normal male and patients with prostatitis, urinary retention or benign prostate hyperplasia . Most of the total circulating PSA (tPSA) is bound as complex PSA, and small part of the circulating PSA is free PSA (fPSA).…”

“…Taking age into consideration when using PSA can reduce unnecessary biopsies. Lim et al . demonstrated age and ethnicity were significant variables associated with PSA level.…”

A Study of Age-Specific Reference Range for Serum Prostate Specific Antigen in South Indian Men

“…for a healthy 60 yr. old man with no evidence of prostate cancer, the serum PSA concentration increased by approximately 3.2 per cent per year (0.04 ng/mL). The study conducted on healthy multi-ethnic Asian population (Malay, Chinese and Indian men) by Lim et al 13 support the concept that the baseline PSA level varies between different ethnicities across all age groups. Therefore, for Indian population also it becomes essential to determine age specific PSA values.…”