Prostate-specific antigen doubling time among Japanese men in an annual health screening program
Article first published online: 12 OCT 2004
International Journal of Urology
Volume 11, Issue 10, pages 856–861, October 2004
How to Cite
TERAI, A., MATSUI, Y., ICHIOKA, K., OHARA, H., TERADA, N. and YOSHIMURA, K. (2004), Prostate-specific antigen doubling time among Japanese men in an annual health screening program. International Journal of Urology, 11: 856–861. doi: 10.1111/j.1442-2042.2004.00904.x
- Issue published online: 12 OCT 2004
- Article first published online: 12 OCT 2004
- Received 1 September 2003; accepted 26 February 2004.
- prostate-specific antigen;
- prostate-specific antigen doubling time;
- multiphasic screening.
Background: Prostate-specific antigen doubling time (PSA-DT) has been studied as a parameter reflecting the biological doubling rate of clinically localized prostate cancer treated expectantly. With the use of PSA-DT, we studied the natural history of PSA changes among Japanese men in a health screening program.
Methods: Between July 1994 and December 2002, a cohort of 1995 men aged 40–79 years underwent a total of 5700 PSA measurements in an annual multiphasic health screening program. Prostate-specific antigen doubling time was calculated using a log-linear regression model for 994 (49.8%) men who had three or more serial PSA measurements with a mean follow-up of 46.2 months.
Results: Of the 994 men, 192 (19.3%) had a PSA-DT of less than 10 years and 12 (1.2%) had a PSA-DT of less than 2 years. Median PSA-DT in 14 men with a subsequent diagnosis of prostate cancer was 41.6 months (range, 12.2 to stable). A log-linear model statistically fitted 65 of 180 non-cancer patients with a PSA-DT of less than 10 years. The percentages of statistically fit cases increased with higher baseline PSA (5.3%, 7.7% and 8.7% among men with <1.0, 1.0–1.99 and 2.0–3.99 ng/mL, respectively) and older baseline age (3.7%, 8.5% and 6.9% among ages 40–49, 50–59 and 60 or older, respectively).
Conclusion: In a small but significant portion of men, PSA increases exponentially when it is still less than 4.0 ng/mL, with a PSA-DT of less than 10 years. The clinical significance of this finding should be evaluated by a prospective screening including biopsy.