Age-specific prostate specific antigen and prostate specific antigen density values in a community-based Indian population

Introduction: We sought to determine the distribution of serum prostate specific antigen (PSA) levels in a community based population in the state of Gujarat in India. Materials and Methods: Community screening of subjects residing in Kheda and Anand districts of Gujarat was done with digital rectal examination (DRE), uroflowmetry and transabdominal sonography and serum PSA. In three villages transrectal sonography was done in addition to transabdominal sonography. All patients with a PSA of more than 4 ng/ml and / or abnormal DRE were evaluated. Biopsy-proven prostatic malignancy was detected in 20 patients. Subjects who did not follow up and who had biopsy-proven malignancy were excluded from the analysis, 1899 subjects were analyzed. Results: One thousand seven hundred and eighty-seven (89.17%) had a PSA of <4 ngml, 180 (8.9%) had a PSA between 4-10 ng/ ml, while 37 (1.8 %) had a PSA more than 10ng/ml. There was a statistically significant correlation between age and prostate volume (correlation coefficient 0.33) and between prostate volume and PSA (correlation coefficient 0.50). The age-specific PSA values derived as the 95 th percentile value were as follows, 40-49 years (0-2.1), 50-59 years (0-3.4), 60-69 years (0-4.2) and more than 70 years (0-5.0). The 95 th percentile value for PSAD was 0.19. Conclusion: Indians need to have separate PSA reference ranges. The age-specific PSA ranges for men in the present study population are on the lower side and the prostate specific antigen density on the higher side.