Men between 40 and 50 years old should be considered for biopsy at lower levels according to research at Duke University.

An article published in the BJU International conclude that lower PSA thresholds for men under 50 are appropriate because norms are lower than in older men.

The research studied just over 12,000 men between the ages of 40 and 96 with at least two PSA tests during a two year period. Of 1622 men diagnosed with prostate cancer, 40 were below age 50. Of the 962 men under 50, the median PSA was 1.3 ng/mL for those with prostate cancer and 0.7 ng/mL for those without.

The researchers are suggesting that for men under 50, biopsies be performed on men with a PSA level of between 2.0 and 2.5 ng/mL. This would adjust the sensitivity of the test at about 74 percent with a 93 percent specificity. They also recommend adjusting the PSA velocity threshold to between 0.2 and 0.6 ng/mL/year.

The researcher opine that PSA screening in men in this age group is more likely to detect men with localized cancer that is easily treated, and PSA level are less affected by BPH which reduces false positives.

Source: BJU Int 2007;99:753-757.