A Single PSA Test before 50 Has Important Implications

The value of prostate specific antigen (PSA) testing has become controversial – more so, recently. However, there’s a study from Sweden reported in BioMed Central that suggests having the test done before the age of 50 may help predict whether there’s a risk of advanced prostate cancer 25 years later, or not. It remains to be seen if this finding is refuted by subsequent studies, but in the meantime the value of early testing seems pretty clear.

Frozen blood samples were available from 462 men with an average age of 47 who subsequently developed cancer of the prostate. The patients’ average age at diagnosis was 64. Three men, matched for age and date of blood sampling and who didn’t have prostate cancer, were chosen as ‘matched controls’ for each cancer patient.

Those men with bony metastases or whose cancer had spread outside the bounds of the prostate were considered as having ‘advanced cancer’. Such men had higher average levels of total PSA in their frozen blood samples compared with the values for the matched controls. An increase of 1 – 2 nanogram/mL in PSA was associated with a 7-fold increased risk of advanced cancer, and a PSA increase of 2 - 3 nanogram/mL with a 22-fold increased risk. Most of the advanced cancers (66%) occurred in the 29% population with the highest PSA levels.

In other words, a raised PSA before 50 can warn you of the risk of advanced prostate cancer within the next 15 years or so. It’s something worth knowing. Don’t ignore the offers of a free PSA at prostate cancer awareness clinics around the country, no matter what you may have heard (or read) about the value of PSA testing!