First PSA Results Predict Long-Term Prostate Cancer Risk

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SAN FRANCISCO—PSA levels at the first date of testing may predict a man's long-term risk of prostate cancer and mortality in the general population, Danish investigators reported here at the annual Genitourinary Cancers Symposium.

The finding could have implications for planning how frequently a man should have additional PSA tests, investigator David D. Ørsted, MD, told listeners.

In a prospective study of 4,383 men aged 20-94 years who had a median follow-up of 18 years, Dr. Ørsted and colleagues at Copenhagen University Hospital found that PCa incidence rose with increasing initial PSA results. Compared with individuals who had an initial PSA level of 0.01-1.00 ng/mL, those with levels of 1.01-2.00, 2.01-3.00, 3.01-4.00, 4.01-10.00, and greater than 10 ng/mL had a 3.0, 6.8, 6.6, 16, and 57 times increased risk of PCa risk, respectively, and a 2.2, 5.1, 4.2, 7.0, and 14 times increased risk of death from PCa.

For men with a first PSA test result of 0.01-1.00 ng/mL, the absolute 10-year risk of PCa was 0.6%, 0.7%, 1.1%, 1.2%, 1.3%, 1.1%, 1.3%, and 1.5% for men younger than 45, 45.49, 50-54, 55.59, 60-64, 65-69, 70-74, and 75 and older. The corresponding risks for those with PSA levels above 10 ng/mL were 35%, 41%, 63%, 71%, 77%, 69%, 75%, and 88%, respectively.

The symposium is co-sponsored by the American Society of Clinical Oncology, the American Society of Radiation Oncology, and the Society of Urologic Oncology.

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