MAKING PSA MORE MEANINGFUL: PSA AND A MAN’S AGE
Which brings us to PSA and age. The theory here is this: As a man ages, his prostate gets bigger. Therefore, why should the PSA cutoff point be the same for a 40-year-old man as for an 80-year-old man (who probably has a higher PSA level anyway, due to BPH)? In a study led by the
Mayo Clinic, doctors determined age-specific ranges for PSA: Lower than the current 4 for younger men (with a life expectancy of 25 to 30 years); and higher than 4—which probably is too severe—for older men. They recommended a cutoff of 2.5 for men aged 40-49; of 3.5 for men aged 50-59; of 4.5 for men aged 60-69; and of 6.5 for men aged 70-79.
“The age-specific reference ranges should make PSA a more selective tumor marker,” the researchers said, “such that significant prostate cancers can be identified at an early, curable stage in men who are most likely to have the greatest benefit from definitive therapy and unnecessary diagnostic procedures would not be performed routinely in men who are unlikely to harbor a life-threatening prostatic malignancy or benefit from therapy.” (One note here is that the higher upper limit for men over age 60 may mean that some potentially curable cancers are not detected as early. The investigators plan to confront this issue in further research.)
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