PROSTATE-SPECIFIC ANTIGEN IN A COMMUNITY SCREENING-PROGRAM

Background. This study was designed to determine who participates in c ommunity-based prostate-specific antigen (PSA) screening programs and what serum PSA levels can be expected. Methods. A descriptive analysis of men who participated in an annual community health screening progr am was used to compare men who chose PSA screening with those who did not. The relationship of demographic variables to PSA level was evalua ted by multivariate regression analysis. Data were available on 5545 m en, 6% of whom were black. Results. The population of PSA screening pa rticipants included proportionately more middle-aged white men with hi gher median income, as compared with men who did not participate. Thos e who did not participate in the screening were more likely to be eith er very old or very young. PSA levels increased with age, and the perc entage of men with elevated PSA levels increased with age. One tenth ( 9.6%) of all participants had PSAs between 4 ng/mL and 10 ng/mL, and 1 .9% had levels greater than 10 ng/mL. Within 1 year of the screening, 1.7% of the screened participants had a diagnosis of prostate cancer. The mean PSA in this group was 15.9 ng/mL. Conclusions. These data con firm the need for age-specific PSA reference ranges. It is likely that the same reference range can be used for ail racial and ethnic popula tions.