臺北市攝護腺癌之篩檢分析

Screening for Prostate Cancer in Taipei City

10.6200/TCMJ.2012.9.4.06

盧星華(Shing-Hwa Lu)；張彰琦(Chang-Chi Chang)；邱文祥(Allen. W. Chiu)；劉志光(Chih-Kuang Liu)；柯明中(Ming-Chung Ko)；陳修聖(Shiou-Sheng Chen)；郭育成(Yuh-Chen Kuo)；陳證文(Cheng-Wen Chen)

攝護腺特異抗原 ； 身體質量指數 ； 年齡 ； 攝護腺癌 ； PSA ； BMI ； age ； prostate cancer

北市醫學雜誌

9卷4期（2012 / 12 / 01）

359 - 373

繁體中文

Objective: The purpose of this study was to establish reference ranges for age specific PSA levels and identify any correlation between BMI and serum PSA levels using a community based survey of healthy males from Taipei City. Methods: From September 2009 to June 2011, 4,947 male (mean age 57.3 year-old, range between 40 and 94 yearold), who are older than 40 years old and lived in Taipei City were enrolled. The dataset related to 3,976 male subjects was subject to the statistical analysis. Past medical history, family history related to prostate cancer, serum PSA level, BMI and the results of a digital rectal examination (DRE) were recorded. The male participants with a PSA level greater than 2.5 ng/ml or AN abnormal DRE were referred to the hospital for further diagnosis and treatment. Those subjects with a history of prostate cancer, missing data, or who underwent a repeat examination were excluded. Finally, the dataset related to 4,010 participants was analyzed statistically. Results: The mean BMI value was 24.6kg/m^2 and the median PSA value was 1.20 ng/mL. The age-specific PSA reference value (95% percentile) were 2.51 ng/mL, 4.40 ng/mL, 6.68 ng/ mL, 10.6 ng/mL and 13.2 ng/mL for the age groups 40-49.9, 50-59.9, 60-69.9, 70-79.9, and over 80 years old, respectively, and there were found to be significant differences in PSA values across the different age groups (p＜0.01). The participants with a family history of prostate cancer had higher PSA values compared to those without a family history of prostate cancer. The participants with a BMI ≥30kg/ m2 had significantly lower PSA values compared with those with a BMI 18.5-＜22kg/m^2. Conclusions: Males with a higher BMI tend to have a lower PSA value. The reference ranges for age-specific PSA values in Taipei City have been established. The adoption of a higher PSA values for the older age groups may be beneficial to the policy makers as it will avoid unnecessary investigations in elderly men who have higher PSA values. However, in order to avoid any delay in diagnosis, clinicians should make decisions depending on the individual's specific condition.

Objective: The purpose of this study was to establish reference ranges for age specific PSA levels and identify any correlation between BMI and serum PSA levels using a community based survey of healthy males from Taipei City. Methods: From September 2009 to June 2011, 4,947 male (mean age 57.3 year-old, range between 40 and 94 yearold), who are older than 40 years old and lived in Taipei City were enrolled. The dataset related to 3,976 male subjects was subject to the statistical analysis. Past medical history, family history related to prostate cancer, serum PSA level, BMI and the results of a digital rectal examination (DRE) were recorded. The male participants with a PSA level greater than 2.5 ng/ml or AN abnormal DRE were referred to the hospital for further diagnosis and treatment. Those subjects with a history of prostate cancer, missing data, or who underwent a repeat examination were excluded. Finally, the dataset related to 4,010 participants was analyzed statistically. Results: The mean BMI value was 24.6kg/m^2 and the median PSA value was 1.20 ng/mL. The age-specific PSA reference value (95% percentile) were 2.51 ng/mL, 4.40 ng/mL, 6.68 ng/ mL, 10.6 ng/mL and 13.2 ng/mL for the age groups 40-49.9, 50-59.9, 60-69.9, 70-79.9, and over 80 years old, respectively, and there were found to be significant differences in PSA values across the different age groups (p＜0.01). The participants with a family history of prostate cancer had higher PSA values compared to those without a family history of prostate cancer. The participants with a BMI ≥30kg/ m2 had significantly lower PSA values compared with those with a BMI 18.5-＜22kg/m^2. Conclusions: Males with a higher BMI tend to have a lower PSA value. The reference ranges for age-specific PSA values in Taipei City have been established. The adoption of a higher PSA values for the older age groups may be beneficial to the policy makers as it will avoid unnecessary investigations in elderly men who have higher PSA values. However, in order to avoid any delay in diagnosis, clinicians should make decisions depending on the individual's specific condition.