PSA in Midlife Can Predict Later Risk of Prostate Cancer Mets
PSA at age 40 to 55 correlates with risk of death or metastasis during 25 to 30 years of follow-up
WEDNESDAY, April 17 (HealthDay News) -- Prostate-specific antigen (PSA) concentrations in midlife can be used to predict the long-term risk of prostate cancer metastasis or death from prostate cancer, according to a study published online April 16 in BMJ.
Andrew J. Vickers, Ph.D., from the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues examined the correlation between PSA concentration at age 40 to 55 and the subsequent risk of prostate cancer metastasis and mortality. Participants included 21,277 Swedish men aged 27 to 52 years who provided a blood sample at baseline and 4,922 men who provided a second sample six years later. Patients were followed for a mean of 27 years.
The researchers identified a correlation between the risk of death from prostate cancer and baseline PSA (44 percent of deaths occurred in men with a PSA concentration in the highest 10 percent at age 45 to 49; a similar proportion was seen for men in the highest 10 percent at age 51 to 55 years). At age 45 to 49 or age 51 to 55, the 15-year risk of prostate cancer metastasis remained low for those with a PSA concentration below the median (0.09 and 0.28 percent risk, respectively). A 25-to-30-year risk of prostate cancer metastasis could not be ruled out by having PSA concentrations below the median during these age ranges.
"Measurement of PSA concentration in early midlife can identify a small group of men at increased risk of prostate cancer metastasis several decades later," the authors write. "Careful surveillance is warranted in these men."
Several authors disclosed financial ties to the pharmaceutical industry; three authors are named as co-inventors on a patent application for a statistical method to predict the result of prostate biopsy.