PSA levels measured at age 60 predict a man’s lifetime risk of metastasis and death from prostate cancer (PCa), according to a study published online in the British Medical Journal.

Hans Lilja, MD, PhD, of Memorial Sloan-Kettering Cancer Center in New York and colleagues studied data from 1,167 Swedish men 60 years of age who provided blood samples in 1981 and were followed up to age 85. Only a minority of men age 60 with PSA levels higher than 2 ng/mL experienced fatal PCa, but 90% of PCa deaths occurred in these men. Men with a PSA level of 2 or higher at age 60 have 17 times and 26 times increased odds of metastasis and death from PCa, respectively, than men with PSA levels of 0.65-0.99.

In contrast, men age 60 with PSA levels at or below the median (1 ng/mL) had a 0.5% risk of metastasis by age 85 and 0.2% risk of death from PCa. Although these men may harbor PCa, it is unlikely to become life threatening, the authors concluded. “Such men could be exempted from further screening, which should instead focus on men with higher [PSA] concentrations,” they wrote.

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