title: Baseline prostate-specific antigen compared with median prostate-specific antigen for age group as predictor of prostate cancer risk in men younger than 60 years old.
abstract: OBJECTIVE
  Limited data are available concerning the extent to which the initial prostate-specific antigen (PSA) measurement in men younger than age 60 predicts for the risk of prostate cancer (CaP) and how this compares to other known risk factors.
  
  
  METHODS
  From 1991 to 2001, 13,943 men younger than 60 years old participated in a CaP screening study. Men aged 40 to 49 years were eligible for the study if they had a positive family history or African-American heritage, and men older than 50 years were screened without respect to risk factors. The CaP detection rate, PSA velocity, pathologic features, and treatment outcomes were evaluated as a function of the baseline PSA level.
  
  
  RESULTS
  The median PSA level was 0.7 ng/mL for men aged 40 to 49 years and 0.9 ng/mL for men aged 50 to 59. A baseline PSA level between the median and 2.5 ng/mL was associated with a 14.6-fold and 7.6-fold increased risk of CaP in men aged 40 to 49 and 50 to 59 years, respectively. A greater baseline PSA value was also associated with a significantly greater PSA velocity, more aggressive tumor features, a greater biochemical progression rate, and a trend toward a greater cancer-specific mortality rate.
  
  
  CONCLUSIONS
  In men younger than 60, a baseline PSA value between the age-specific median and 2.5 ng/mL was a significant predictor of later CaP and was associated with a significantly greater PSA velocity. A young man's baseline PSA value was a stronger predictor of CaP than family history, race, or suspicious digital rectal examination findings. A greater baseline PSA level was associated with significantly more adverse pathologic features and biochemical progression.
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
authors.forename: Stacy
authors.initials: S
authors.lastname: Loeb
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Roehl
authors.forename: Jo Ann V
authors.initials: JA
authors.lastname: Antenor
authors.forename: William J
authors.initials: WJ
authors.lastname: Catalona
authors.forename: Brian K
authors.initials: BK
authors.lastname: Suarez
authors.forename: Robert B
authors.initials: RB
authors.lastname: Nadler
mesh_terms: D000328:Adult; D000367:Age Factors; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen