Distributions and characteristics of initial PSA and PSA velocity in Chinese men aged 50 years and younger without prostate cancer: a multi-center study

Purpose: To explore the distributions and characteristics of initial prostate-specific antigen (PSA) and PSA velocity in men aged <= 50 years without prostate cancer. Methods: The initial PSA test of men aged <= 50 years, taken from January 2001 to November 2009, were retrospectively analyzed. Cases with prostate cancer were excluded. The distributions of initial PSA and PSA velocity, and the correlations between these two values were estimated. Kaplan-Meier and log-rank test were used to estimate significant differences on the risk of PSA >= 2.5 ng/mL after initial PSA measurement, stratified by median initial PSA (0.6 ng/mL). Results: A total of 4,206 men without prostate cancer were included in this study. The median initial PSA value was 0.6 ng/mL. A total of 417 men had their PSA measured two times or more and the median PSA velocity was 0.028 ngxmL(-1)x yr(-1).There was no two-two direct correlation between initial PSA testing age, initial PSA, and PSA velocity. After a follow-up of up to 7.1 years from the baseline PSA measurement, the risk of PSA >= 2.5 ng/mL, stratified by median initial PSA (0.6 ng/mL), was significantly different (log-rank test, p<0.001). Conclusion: More than 20% of the men aged <= 50 years should have regularly PSA screening based on current guidelines. However, the subsequently risk of being diagnosed with prostate cancer in these men is not known. Men aged <= 50 years with an initial PSA higher than the median (0.6 ng/mL) have a subsequently higher risk of abnormal PSA value.