Andrology-Open Access
Open Access

Abstract

Redefining Prostate Cancer Diagnosis: The Global Discourse on Single PSA Cut-Off Level in Diverse Populations

Dr. Edwin Nkemjika Okafor*, Dr. Ezra O Agbo, Dr. Innocent Okonkwo, Dr. Blessing Okpagu

Controversy surrounds the use of Prostate Specific Antigen (PSA) as a definitive marker for identifying Prostate Cancer (PCa), despite its alarming incidence and mortality rates. This in-depth mini review examines recent published article and relevant literature analyzing the complex link between PCa and various risk factors. It also examines the potential of age-specific prostate-specific antigen reference intervals (ASRLs) as an alternative to a single PSA cutoff value. Our review uncovers that PCa is primarily rooted in advancing age and genetic predisposition (shared genes), with its impact further influenced by factors such as race, environmental conditions, lifestyle, and human development index. The existing studies suggest that ASRLs provide a viable alternative to overcome the limitations of relying on a single PSA cutoff value. Data from men belonging to different populations were analyzed for establishing ASRLs in accordance with the International Federation of Clinical Chemistry guideline. Spearman correlation analysis was used, with a significance threshold of P values<0.5. ASRLs were determined by utilizing the 95th percentile and PSA values within each 10-year age group, covering age groups 30-39, 40-49, 50-59, 60-69, 70-79 and ≥ 80 years. A positive correlation between PSA levels and age groups was observed. Furthermore, the review delves into the variation of PSA levels across different ethnicities. Synthesizing the findings, this review suggests that ASRLs may offer higher sensitivity compared to a single cutoff value, emphasizing the need for a nuanced approach to characterizing PSA based on both age and ethnicity.

Published Date: 2025-12-29;