PSA kinetics before 40 years of age

Vol. 44 (x): 2018 September 9.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2017.0710


Cristiano Linck Pazeto 1, Thiago Fernandes Negris Lima 1, José Carlos Truzzi 2, Nairo Sumita 2, José de Sá 2, Fernando R. Oliveira3, Sidney Glina 1
1 Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil; 2 Fleury Medicina e Saúde São Paulo, SP, Brasil; 3 Departamento de Epidemiologia, Universidade de São Paulo, São Paulo, SP, Brasil


Purpose: The baseline PSA has been proposed as a possible marker for prostate cancer.

The PSA determination before 40 years seems interesting because it not suffers yet the drawbacks related to more advanced ages. Considering the scarcity of data on this topic, an analysis of PSA kinetics in this period seems interesting.

Materials and Methods: A retrospective assay in a database of a private diagnostic center was performed from 2003 to 2016. All subjects with a PSA before 40 years were included.

Results: 92995 patients performed PSA between the ages of 21 – 39. The mean value ranged from 0.66 ng / mL (at age 22) to 0.76 ng / mL (at age 39) and the overall mean was 0.73 ng / mL. As for outliers, 3783 individuals presented a baseline PSA > 1.6 ng / mL (p95). A linear regression model showed that each year there is a PSA increase of 0.0055 ng / mL (β = 0.0055; r² = 0.0020; p < 0.001). A plateau in PSA between 23 and 32 years was found and there were only minimal variations among the ages regardless of the evaluated percentile.

Conclusion: It was demonstrated that PSA kinetics before 40 years is a very slow and progressive phenomenon regardless of the assessed percentile. Considering our results, it could be suggested that any PSA performed in this period could represent the baseline value without significant distortions.

Keywords: Prostate-Specific Antigen; Kinetics, Prostatic Neoplasms

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