The distribution of serum prostate-specific antigen levels among American men: implications for prostate cancer prevalence and screening.
BACKGROUND
The purpose of this study was to describe the distribution of serum prostate-specific antigen (PSA) among American men and to estimate the number of prevalent cases of biopsy detectable prostate cancer among men with normal serum PSA.


METHODS
We analyzed data of the National Health and Nutrition Examination Survey 2001-2002 (NHANES 2001-2002) data and combined these results with published data from the Prostate Cancer Prevention Trial (PCPT).


RESULTS
Most men in the US have a serum PSA < or = 4.0 ng/ml, and mean and median serum PSA values rise steadily with age. There are an estimated 1,607,585 (95% CI 1,370,848-1,844,322) prevalent cases of biopsy detectable prostate cancer in men aged 62-85 years with a serum PSA < or = 4 ng/ml. Among men aged 62-75 years, there are an estimated 1,252,143 (95% CI 1,054,677-1,449,609) prevalent cases, including an estimated 195,499 (95% CI 140,234-250,764) high-grade tumors.


CONCLUSIONS
A large number of prevalent cases of biopsy detectable prostate cancer exist in American men with a normal PSA.
Porter
Michael P
MP
Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA. mporter@u.washington.edu
Stanford
Janet L
JL
Lange
Paul H
PH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D012016:Reference Values; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D017430:Prostate-Specific Antigen