Age-Specific PSA Reference Values Based on a Screening Population of British Men

Abstract

Objective:

Age-specific PSA reference values are recommended by the Department of Health and NICE as a referral trigger for men with abnormal PSA values. They are arbitrary values in the UK and are based on the international literature.

Patients and methods:

Data of 1970 men with benign histology from the Gwent screening study were used out of a cohort of 2063 men. The adaptive trimmed maximum likelihood method as the best way of removing outliers which do not come from a log-normal distribution was used after data transformation. The 95% percentile was used as cut-off value.

Results:

The true statistical 95% percentile for PSA in a screening population for the age groups 50–59.9 years, 60–69.9 years and 70–79.9 years are 3.2ng/ml, 5.6ng/ml and 8.1 ng/ml, respectively.

Conclusions:

These values differ from the recommended referral cut-off values by the Department of Health. The adoption of higher values for the older age groups may be a sensible policy to avoid unnecessary investigation in elder men with high PSA values due to benign disease.