PSA levels in midlife can be used to predict the long-term risk of prostate cancer (PCa) metastasis or PCa-related death, according to findings published online in the British Medical Journal.
Andrew J. Vickers, PhD, from the Memorial Sloan-Kettering Cancer Center in New York, and colleagues examined the correlation between PSA concentration at age 40 to 55 and the subsequent risk of PCa metastasis and mortality. Participants included 21,277 Swedish men aged 27-52 years who provided a blood sample at baseline and 4,922 men who provided a second sample six years later. Patients were followed up for a mean of 27 years.
The researchers identified a correlation between the risk of death from prostate cancer and baseline PSA (44% of deaths occurred in men with a PSA concentration in the highest 10% at age 45-49; a similar proportion was seen for men in the highest 10% at age 51-55 years).
At age 45-49 or age 51-55, the 15-year risk of PCa metastasis remained low for those with a PSA concentration below the median (0.09% and 0.28% risk, respectively). A 25-to-30-year risk of PCa metastasis could not be ruled out by having PSA concentrations below the median during these age ranges.
“Measurement of PSA concentration in early midlife can identify a small group of men at increased risk of prostate cancer metastasis several decades later,” the authors concluded. “Careful surveillance is warranted in these men.”