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| Age-specific reference ranges of prostate-specific antigen in the elderly of Amirkola: A population-based study |
Hosseini Seyed Reza,Zabihi Ali( ),Habibian Tara,Bijani Ali
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| Babol University of Medical Sciences, Babol, Iran |
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Abstract Objective To determine the age-specific reference ranges of prostate-specific antigen (PSA) in the older men in the city of Amirkola.
Methods This cross-sectional study is a part of Amirkola Health and Ageing Project (AHAP) which has been conducted as a cohort study since 2011 in Amirkola, a city in northern Iran. The demographic information of all men aged 60 and older were collected through questionnaires and interviews and the PSA measurements were performed using ELISA and Diametra kit. The acquired data were analyzed afterwards.
Results A number of 837 elderly men with a mean age of 69.99±7.72 years participated in this study. The serum PSA level (95th percentile) was determined to be 0.9 (0-4.89) ng/mL in the age group of 60-64 years, 1.1 (0-4.88) ng/mL in the age group of 65-69 years, 0.93 (0-9.01) ng/mL in the age group of 70-74 years, 1.3 (0-7.95) ng/mL in the age group of 75-79 years, 1.9 (0-11.98 ng/mL) in the age group of 80-84 years, and 1.45 (0-33.17) ng/mL in the 85 and older group. The serum PSA level was significantly correlated with age (p=0.000).
Conclusion This study indicated that there is a direct correlation between the age and serum PSA levels. The use of age-specific reference range could guide clinicians on the incidence of prostate cancer in this population and perhaps reduce the number of unnecessary tests in this population group.
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Received: 09 January 2019
Available online: 07 March 2020
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Corresponding Authors:
Zabihi Ali
E-mail: zabihi_alii@yahoo.com
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| Investigated variables | Number | Percent | | Age, year | | 60-64 | 280 | 33.5 | | 65-69 | 163 | 19.5 | | 70-74 | 150 | 17.9 | | 75-79 | 138 | 16.5 | | 80-84 | 64 | 7.6 | | 80+ | 42 | 5.0 | | Educational level | | Illiterate | 508 | 60.7 | | Primary &secondary | 238 | 28.4 | | High school & university | 91 | 10.9 | | Smoking | | No | 548 | 65.5 | | Yes | 289 | 34.5 | | IPSS | | | | Mild | 385 | 46.0 | | Moderate | 165 | 19.7 | | Severe | 287 | 34.3 | | Total | 837 | 100.0 |
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Socio-demographic characteristics of the older adults in the city of Amirkola.
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| Age, year | PSA (ng/mL) | PSA 95% CI (ng/mL) | PSA (ng/mL) | | n | Mean | SD | Lower | Upper | Min | Max | p-Value | | 60-64 | 280 | 1.47 | 1.78 | 1.26 | 1.68 | 0 | 11.5 | 0.000 | | 65-69 | 163 | 1.63 | 2.29 | 1.28 | 1.99 | 0 | 24.7 | | 70-74 | 150 | 2.01 | 3.32 | 1.47 | 2.54 | 0 | 23.6 | | 75-79 | 138 | 2.12 | 2.87 | 1.64 | 2.61 | 0 | 19.9 | | 80-84 | 64 | 3.05 | 4.43 | 1.94 | 4.16 | 0 | 28.0 | | 85+ | 42 | 3.91 | 8.45 | 1.28 | 6.54 | 0 | 40.7 | | Total | 837 | 1.95 | 3.28 | 1.73 | 2.17 | 0 | 40.7 |
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Distribution of serum PSA levels according to age group.
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| Age (year) | Men, n | Serum PSA level (ng/mL) percentile value | | 2.5th | 5th | 10th | 25th | 50tha | 75th | 90th | 95th | 97.5th | | 60-64 | 280 | 0.00 | 0.00 | 0.00 | 0.43 | 0.90 | 1.87 | 3.79 | 4.89 | 6.19 | | 65-69 | 163 | 0.00 | 0.00 | 0.03 | 0.55 | 1.10 | 2.00 | 3.47 | 4.88 | 6.16 | | 70-74 | 150 | 0.00 | 0.00 | 0.00 | 0.31 | 0.93 | 2.35 | 3.87 | 9.01 | 14.25 | | 75-79 | 138 | 0.00 | 0.00 | 0.00 | 0.38 | 1.30 | 2.69 | 5.15 | 7.95 | 12.08 | | 80-84 | 64 | 0.00 | 0.00 | 0.05 | 0.81 | 1.90 | 3.06 | 7.06 | 11.98 | 19.74 | | 85+ | 42 | 0.00 | 0.00 | 0.01 | 0.5 | 1.45 | 2.92 | 5.23 | 33.17 | 40.29 | | Total | 837 | 0.00 | 0.00 | 0.00 | 0.49 | 1.01 | 2.20 | 4.16 | 5.98 | 11.06 |
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Percentile value for serum PSA levels according to age groups.
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Mean serum PSA levels (ng/mL) according to age groups. CI, confidence interval. IPSS, International Prostate Symptoms Scale; PSA, prostate-specific antigen.
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Median serum PSA levels (ng/mL) according to age groups. IPSS, International Prostate Symptoms Scale; PSA, prostate-specific antigen.
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Serum PSA levels (ng/mL) according to the age and International Prostate Symptoms Scale (IPSS) score; PSA, prostate-specific antigen.
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| Age groups (year) | PSA level 95 percentile (ng/mL) in age groups | | Iran (current study) | China (Taiwan) [7] | Saudi Arabia (Al-Khobar) [23] | Singapore [24] | China (Beijing) [12] | US (African-American) [25] | Korea [26] | Iran (Qazvin) [27] | | 60-69 | 4.88 | 5.11 | 5.41 | 4.00 | 4.11 | 11.30 | 4.00 | 5.7 | | 70-79 | 7.89 | 6.24 | 6.29 | 6.31 | 5.56 | 12.50 | 4.55 | 6.8 | | 80+ | 11.99 | 6.61 | 6.84 | 6.61 | 7.29 | -a | 6.18 | - |
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Comparison of serum PSA reference ranges among different countries.
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