Dados do Trabalho

Título

OVER 48,000 PROSTATE SPECIFIC ANTIGEN MEASUREMENTS IN YOUNG MEN: A 15-YEAR TIME-ANALYSIS

Introdução e Objetivo

The objective of this study is to enhance the comprehension of variations in baseline Prostate-Specific Antigen (PSA) levels among young men over recent decades.

Método

This study analyzed baseline total PSA data from 48,896 men under the age of 40, obtained from a private laboratory conglomerate in Brazil. The specifics of the parametric data are detailed in the study. Simple and multiple linear regression models were employed to assess temporal trends over a 15-year span (2003-2017).

Resultados

The mean age and standard deviation were 34.5 ± 4.6 years (minimum age 17). PSA levels were observed to have a median ± interquartile range of 0.63 ± 0.46 ng/dl, with a leftward skew towards zero (81% of results below 1 ng/dl) across all periods analyzed. PSA levels exceeding 4.0 ng/dl and 10 ng/dl were exceedingly rare, with an average of 8.2 and 1.6 observations per 1000 tests, respectively. The average logarithm (base 10) of all PSA results (LogPSA) was calculated for each month to discern time-dependent trends. A multiple linear regression model, which predicted the average LogPSA per month as a function of time, age, and testing rate of that month, indicated that average results were progressively increasing over time, irrespective of age and testing rate (multiple R-squared = 0.40, estimate = 1.211e-05, p<0.0001). Data were categorized into three age groups: below 30 (n = 6123), 30-35 (n = 16,118), and 35-40 (n = 25,351) years old. The mean LogPSA increased in all three age groups over the time period, with nearly identical slopes (estimate = 1.5e-05, 1.5e-05, and 1.2e-5, respectively; P<0.0001 for all three groups).

Conclusão

Average measured PSA in young men below the age of 40 is gradually increasing over time. There are three plausible interpretations: - due to alterations in medical practice (e.g., reserving the test for individuals with a higher likelihood of prostate issues); - increased steroid use within this demographic; - increase in unidentified benign or pathological prostate conditions (e.g., sexually transmitted infections).