Age-specific distribution of serum prostate-specific antigen in a community-based study of African-American men

Objectives. Previous studies have observed higher age-specific serum prosta te-specific antigen (PSA) values in African-American (AA) men without prost ate cancer compared to white men, leading some to recommend race-specific P SA reference ranges for the early detection of prostate cancer. The primary objective of the Flint Men's Health Study was to determine age-specific PS A reference values in a community-based sample of AA men, aged 40 to 79 yea rs. Methods. A probability sample of 943 AA men was selected from households in Genesee County, Michigan. Men without a prior history of prostate cancer/s urgery were invited to participate in a prostate cancer screening protocol, consisting of measurement of serum total PSA, free/total PSA ratio, and di gital rectal examination. Sextant biopsies were recommended, based on total PSA greater than 4.0 ng/mL and/or an abnormal digital rectal examination. Results. From the sample of 943 men. 732 were eligible, 432 had blood drawn for PSA testing, and 374 completed all phases of the clinical examination. The 95th percentile PSA values were estimated to range from 2.36 ng/mL for men in the fifth decade to 5.59 ng/mL for men in the eighth decade. The 95 th percentile values for age-specific PSA were comparable to those observed in a similar study of white men in Olmsted County, Minnesota. The median a nd 5th percentile values for free/total PSA did not vary significantly acro ss age. Conclusions. The minor differences in PSA reference ranges between AA and w hite men may not be of sufficient magnitude to recommend the use of race-sp ecific PSA reference ranges for screening. UROLOGY 57: 91-96, 2001. (C) 200 1, Elsevier Science Inc.