Age-Specific Percentile-based Prostate-Specific Antigen Cutoff Values Predict the Risk of Prostate Cancer: a single hospital observation
Teng‐Fu Hsieh, Hung-Lin Chen, Ying‐Fang Hsia, Che‐Chen Lin, Hsiu‐Yin Chiang, Min-Yen Wu, Sheng-Hsuan Chen, Po‐Fan Hsieh, Hsi‐Chin Wu, Han Chang, Chin‐Chi Kuo
Abstract
Background: Testing for prostate-specific antigen (PSA) is often recommended for men with a potential risk of prostate cancer (PCa) before requiring advanced examination. However, the best PSA cutoff value remains controversial. Object: We compared the predictive performance of age-specific percentile-based PSA thresholds with a conventional cutoff of >4 ng/mL for the risk of PCa. Methods: We included men who received PSA measurements between 2003 and 2017 in a medical center in Taiwan. Logistic regression modeling was used to assess the association between age-specific percentile-based PSA thresholds and PCa risk in age subgroups. We further applied C-statistic and decision curve analysis to compare the predictive performance of age-specific percentile-based PSA with that of a conventional cutoff PSA. Results: < 0.05). The 75th percentile cutoffs also correctly identified an additional 2 patients with PCa for every 100 patients with PSA screening at the threshold probability of 20%. Conclusions: Our data support the use of the 75th percentile PSA cutoff to facilitate individualized risk assessment, particularly for patients aged <60-year-old.