Journal List > Korean J Urol > v.49(2) > 1005047

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Cho, Kim, Kim, Kim, Kim, Kim, Seong, Song, Lee, Yang, Cheon, Cho, Cho, Chung, Choi, Im, and Hong: Lowering Prostate-specific Antigen Threshold for Prostate Biopsy in Korean Men: Impact on the Number Needing Biopsy
Original Article
Korean Journal of Urology

Korean Journal of Urology 2008; 49(2): 118-121.

Published online: 29 February 2008

DOI: https://doi.org/10.4111/kju.2008.49.2.118

Lowering Prostate-specific Antigen Threshold for Prostate Biopsy in Korean Men: Impact on the Number Needing Biopsy

Jin Seon Cho, Sun Il Kim1, Se Joong Kim1, Young Sig Kim2, Chun Il Kim3, Hong Sup Kim4, Do Hwan Seong5, Yun Seob Song6, Dong Hyeon Lee7, Won Jae Yang6, Sang Hyeon Cheon8, Kang Su Cho9, In Rae Cho10, Byung Ha Chung9, Young Deuk Choi9, Hyoungjune Im11, Sung Joon Hong9

Department of Urology, College of Medicine, Hallym University, Chuncheon, Korea.

1Department of Urology, College of Medicine, Ajou University, Suwon, Korea.

2Department of Urology, College of Medicine, Ilsan Hospital, National Health Insurance Corporation, Ilsan, Korea.

3Department of Urology, College of Medicine, Keimyung University, Daegu, Korea.

4Department of Urology, College of Medicine, Konkuk University, Chungju, Korea.

5Department of Urology, College of Medicine, Inha University, Incheon, Korea.

6Department of Urology, College of Medicine, Soonchunhyang University, Korea.

7Department of Urology, College of Medicine, Ewha Womans University, Seoul, Korea.

8Department of Urology, College of Medicine, Ulsan University, Ulsan, Korea.

9Department of Urology, College of Medicine, Yonsei University, Seoul, Korea.

10Department of Urology, College of Medicine, Inje University, Seoul, Korea.

11Department of Occupational and Environmental Medicine, Hallym University, Chuncheon, Korea.

sjhong346@yumc.yonsei.ac.kr

Received 26 June 2007       Accepted 24 December 2007

Copyright © 2008 The Korean Urological Association

Abstract

Purpose

We examined the effect of lowering prostate-specific antigen (PSA) threshold on the number of Korean men requiring a prostate biopsy.

Materials and Methods

We evaluated men who had serum PSA levels tested at routine physical check-ups between 1999 and 2005 at 11 domestic hospitals. Men with PSA ≥ 10ng/ml or patients with prostate cancer were excluded. A total of 45,074 men (aged 50 to 79 years) were enrolled and split into three age groups: 50-59 years, 60-69 years, and 70-79 years. For each age group, we calculated the number and proportion of men whose PSA level exceeded potential biopsy thresholds: 2.5ng/ml, 3.0ng/ml, and 4.0ng/ml. Results were extrapolated to the 4.992 million men older than 50 years old, or 21.3% of the Korean male population in 2005.

Results

The number of biopsy candidates at the threshold of 4.0ng/ml, 3.0ng/ml, and 2.5ng/ml were 1,321 (2.9%), 2,248 (5.4%), and 3,577 (7.9%), respectively. Extrapolating to the male population in Korea, lowering the PSA threshold from 4.0ng/ml to 3.0 or 2.5ng/ml would increase the number of men needing biopsy by 1.75 and 2.49 times, respectively.

Conclusions

Lowering the PSA threshold would increase the number of men receiving prostate biopsy despite the low reference age for PSA in Korea. Considering the low incidence of prostate cancer, physicians should be careful in altering the PSA threshold.

Keywords: Prostate-specific antigen, Biopsy, Threshold

Figures and Tables

Table 1
Distribution of serum PSA levels according to age
kju-49-118-i001

PSA: prostate-specific antigen

Table 2
Proportion of serum PSA levels according to age
kju-49-118-i002

PSA: prostate-specific antigen. Data is presented as the number of subjects, with the percentage in parenthesis.

Table 3
Estimated proportion of serum PSA level according to age in Korean men
kju-49-118-i003

PSA: prostate-specific antigen. Data is presented as the number of subjects (×1,000), with the percentage in parenthesis.

Table 4
Increased ratio of lowering the PSA threshold in Korean population
kju-49-118-i004

PSA: prostate-specific antigen

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