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PSA Levels By Age and Year Question

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Posted 4/30/2012 3:27 PM (GMT -5)
Can someone tell me what the PSA guidelines were/are for the years 2003, 2004, & 2005?

Were these within normal range?

2003 - PSA 2.4 (Age 42)
2004 - PSA 2.2 (Age 43)
2006 - PSA 4.6 (Age 45) - I know this one was not in normal range

If, so... where can I find a reputable data link?

Thanks!
Posted 4/30/2012 3:34 PM (GMT -5)
My latest lab report cites 0.00 - 4.00 as "normal" without qualification for age.
Posted 4/30/2012 4:02 PM (GMT -5)
Age is a key component. In talking to my urologist (at Hopkins), he said there was no good explanation other than PCa with a PSA of 3.7 and positive DRE for a man in his early 40's. He was convinced before the biopsy was even done that I had PCa. He also said, and I have found NO internet data to back it up, that a man in his 40's--- especially early 40's, should have a fractional percent PSA number. Something like .8 was his example. I trust his experience in this assessment. He did say that BPH can cause PSA elevation but that would be revealed with a DRE. Barring a large prostate in one's early 40's, it seems to me from talking with him that PCa is then the immediate concern.

Somewhere I did read that the PSA number for 40 somethings that would be of concern would be higher than a 2.0. I've lost all my links in a computer rebuild, but 2-2.5 rings a bell. Mine was 2.8 so it raised my eyebrow when I read it. It was the only data I read that intimated at what my uro said.
Posted 4/30/2012 4:08 PM (GMT -5)
One of my routine reports I used to get for PSA results listed the following ranges by age and race, 95% sensitivity:

  • <2.5 for white, <2.0 for black, <2.0 for Asian in the age range of 40-49.
  • <3.5, <4.0, <3.0 for ages 50-59
  • <4.5, <4.5. <4.0 for ages 60-69
  • <6.5, <5.5, <5.0 for ages 70-79
Posted 4/30/2012 4:09 PM (GMT -5)
My long term GP, still uses .00 to 4.00 as the "normal" range for a PSA reading, and it doesn't factor in any age variables.
Posted 4/30/2012 4:29 PM (GMT -5)
Thanks all!

Dude, I also read something about above 2.0 in the 40's, but can't seem to put my hands on it.

Also, I don't know if that was the standard back in 2003 and 2004.

SC, Can you say which lab indicates that? If not, I understand.

I really need this info, but need to make sure what the standard was back in 2003 and 2004.

Any help appreciated. :)
Posted 4/30/2012 4:43 PM (GMT -5)
MsWorryWart,

I sent you an email with a PDF attachment listing the ranges, the article references for the ranges, and the lab name.

Posted 4/30/2012 4:43 PM (GMT -5)
google search "psa level for 40 year old"


http://www.healthcentral.com/prostate/psa-225336-5.html

Not sure when things were "redefined." This might have been the search I used and actually found this place. It was I think the third hit on the search. I recall just following the "bread crumb trail" as I read about this subject. By the time I was done, I was certain I was dealing with PCa. This was even before meeting my uro/ surgeon.
Posted 4/30/2012 4:50 PM (GMT -5)
Thanks for the link!

It took me forever to find some info, and apparently I hid the links from myself. :)
Posted 4/30/2012 4:51 PM (GMT -5)
SC.... Thanks!
Posted 4/30/2012 4:55 PM (GMT -5)
my urologist said a psa of 2.0 at my age wasn't normal, probably wasn't anything, but required a biopsy.
Posted 4/30/2012 5:06 PM (GMT -5)
I did have some 1st ed. copies of the more common books than dated back to those years, but have trashed them. There isn't space for out of date books. You might look at your local library. I have seen some old Walsh editions at mine.

I do have a 2006 copyright "Surviving Prostate Cancer" by E. Fuller Torrey, M.D.

It cites (pg. 13):

"Many urologists now use age-corrected limits for normal PSA levels ...

The following have been recommended:

Ages 40-49: Upper limit of 2.5

Ages 50-59: Upper limit of 3.5

...

Not everyone agrees on these figures."

The implication of the several pages is that that age-related limits were really new stuff in 2006.

Posted 4/30/2012 6:06 PM (GMT -5)
I have records back to 1996 and they all indicate the 'acceptable' range was 0 to 4.0. That's all I have ever seen it on my doctors lab reports from 1996 to the present day. No one that I know uses any thing but that 0 to 4.0 standard.
Posted 4/30/2012 6:40 PM (GMT -5)
The benign prostate gives off about .066 ng/ml of PSA per cubic centimeter of prostate volume. As a man ages it is natural for the prostate to enlarge, thus a score that is ok at age 60 could be alarming at age 40. In a younger man, say 45, prostate volume of 30cc is in the normal range and would produce about 1.98 PSA. So, for example, a PSA of 3.5 should raise eyebrows and indicate more investigation.

I was diagnosed at age 60 and the ct scan indicated a prostate size of 38cc, thus a PSA of 2.51 would be fine. If it was, say, 4.5 then it would either mean a very enlarged prostate of some 68.18cc or other issues would be present such as infection, BPH or PCa. Thus, the guidelines are a good starting point for a biopsy particularly if the DRE indicates a much smaller gland.

I use Bostwick for PSA tests and the chart refers to a normal range of .1 to 4.5, without regard to age or condition.
Posted 4/30/2012 7:13 PM (GMT -5)
DavidG... Thanks for that info.

142... Excellent suggestion, will follow up with that.

James C... My husband's PSA test now indicate anything under 4.0.... But I do know that I have seen other information indicating values per age. Actually, another member just sent me a PDF of one that is age specific.

I did find these links...

http://www.realage.com/mens-health/normal-psa-values (2009)
http://www.prostatecancerweek.org/members/Basics/PSA.htm (Unable To Locate Date)
http://www.buzzle.com/articles/normal-psa-levels.html (2011)
http://www.psa-rising.com/prostatecancer/fpsa-flowchart.htm (2009)
www.auncurology.com/assets/pdf/psa_interpretation.pdf

Just looking for something solid. Not sure the above are considered a solid source.
Posted 4/30/2012 7:16 PM (GMT -5)
142... is the age related was new in 2006, I guess I can mostly assume that it was not in effect in 2003. :)

Thanks for posting that!
Posted 5/1/2012 8:37 AM (GMT -5)
Just for the record, my GP's comment after a DRE in July 2010 was, "...it feels soft and lumpy. Let's give you a PSA to be sure." It came back at 2.6. He said we'd keep an eye on it. DRE at physical in July 2011, "...everything feels normal, a little firm, perhaps. Let's do another PSA and see what it says." Came back 3.8 and he referred me. He was clearly working on two recommended standards: Questionable DRE and a PSA that increased more than .70 in a year. He also mentioned I was probably good as long as I was below 4.0. So he definitely worked on the 0-4 scale recommendation, as well. It was my own reading that made me ask questions to the first urologist that my GP sent me to. As I didn't like his answers or manner, I got a recommendation to Hopkins, where my uro/ surgeon unequivocally stated that a man my age should not have a psa above 1.0 in normal situations and generally that it should be lower than that even.

The 0-4 is just a scale to be taken into account with all the other factors of the investigation prior to recommending the biopsy for confirmation. But there's definitely info out there, that my uro/ surgeon was obviously privy to about another scale for younger men... or at least a revised scale.
Posted 5/1/2012 10:41 AM (GMT -5)
Hello,

If you go to Pub Med (the national free database of medical abstracts) www.ncbi.nlm.nih.gov/pubmed/ and type in the following search phrase, you will find many, many articles that discuss this issue in detail. It was a very popular topic from 1995 to 2005. You will find all kinds of analysis, so perhaps you'll find some that are helpful.

Search phase: age specific reference ranges for serum prostate-specific antigen

Best wishes,
Nellie
Posted 5/3/2012 2:13 PM (GMT -5)
Thanks JNF and others.

Nellie, thanks for the link and search info. I have been going through it as time permits and it is very interesting.

Thanks again everyone.

PS... Day 7 of radiation now behind us with no side effects to speak of. :)
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