Prostate-specific antigen velocity in healthy Korean men with initial PSA levels of 4.0 ng/mL or less.
OBJECTIVE
To assess the longitudinal changes in serial prostate-specific antigen (PSA) levels in healthy Korean men with initial PSA levels of 4.0 ng/mL.


METHODS
The rate of PSA change or PSA velocity (PSAV) in 24 869 healthy men with an initial PSA level of 4.0 ng/mL or less who were clinically free of genitourinary disease was analyzed at intervals of at least 12 months. The influence of age, initial PSA level, and the interval between measurements was assessed.


RESULTS
The mean age, initial PSA level, interval between measurements, and change in PSA and PSAV was 46.2 years, 0.86 ng/mL, 21.9 months, and 0.03 ng/mL and 0.02 ng/mL/y, respectively. A cumulative frequency plot of PSAV demonstrated that 50%, 95%, and 97% of subjects had a PSAV of 0.01, 0.40, and 0.52 ng/mL/y or less, respectively. The PSAV correlated with age, initial PSA level, and interval between measurements. The percentage of men with a PSAV greater than 0.75 ng/mL/y was 0.61% (151 of 24 869) and was 0.51% (92 of 17 985) for those with an initial PSA level of less than 1.0 ng/mL, 0.86% (50 of 5807) for those with a PSA level of 1.1-2.0 ng/mL, and 0.84% (9 of 1077) for those with an initial PSA level of 2.1-4.0 ng/mL.


CONCLUSIONS
In healthy Korean men with an initial PSA level of 4.0 ng/mL or less, most will have a PSAV of less than 0.75 ng/mL/y. Thus, traditional PSAV cutoff values are not applicable in this population. We propose that a lower PSAV cutoff value should be used to indicate biopsy. Additional large-scale prospective studies, including biopsy data, are required to assess the cutoff value of PSAV for healthy Korean men with a PSA level of 4.0 ng/mL or less.
Department of Urology and Urological Science Institute, Clinical Trials Center, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea.
Won Sik
WS
Ham
Dae Ryong
DR
Kang
Young Sig
YS
Kim
Do Hwan
do H
Seong
Se Joong
SJ
Kim
Sang Hyeon
SH
Cheon
In Rae
IR
Cho
Jin Seon
JS
Cho
Chun Il
CI
Kim
Young Deuk
YD
Choi
D000328:Adult; D000368:Aged; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D012016:Reference Values
D017430:Prostate-Specific Antigen