Age-specific reference range of prostate-specific antigen among indian men: A retrospective observational study

Background: Prostate cancer (CaP) has a varied occurrence across the globe. Serum Prostate Specific Antigen (PSA) level is influenced by various factors which include race and ethnicity, environmental factors, lifestyle, metabolic changes, physiologic changes and advancing age. Data is scarce regarding reference range for Indian population. Aim and Objectives: To determine age specific serum PSA level in apparently healthy south Indian men. Material and Methods: Reports of 5199 adult males tested for serum total PSA were screened. Persons with PSA >20ng/ml were excluded from the study. A total of 4583 apparently healthy adult men from tertiary care hospital in Mangaluru, India were included as subjects. The median serum PSA levels were calculated in each 10year age group for Indian males. These were compared with age specific reference range reported in different populations across the country and also among different ethnicities across the globe. The data was analysed using SPSS 16.0, Inc, Chicago, IL. Results: The median PSA value was 0.76 ng/ml in subjects younger than 50 years; 0.97 ng/ml in 50-59 years group; 1.38 ng/ml in 60-69 years group; 1.89 ng/ml in 70-79 years group and 2.19 ng/ml in persons older than 80 years. We found a positive correlation between age and serum PSA levels. Conclusions: PSA is influenced by various factors which makes depending on a single reference for all age groups a questionable practice. This study highlights the need to establish age specific reference ranges for different populations.