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Men in their 40s and 50s who test above
average for the marker for prostate
cancer known as prostate-specific
antigen (PSA) have a threefold chance of developing
the disease later in life and may benefit from earlier screening.
"Men whose PSA was above the median
were at significantly increased risk for the next 25 years
for developing prostate cancer," senior author Dr. H.
Ballentine Carter, a professor of urology at the Johns Hopkins
University School of Medicine in Bethesda, Maryland, told
Reuters Health.
PSA is a substance normally produced
by the prostate gland that can serve as an indication of prostate
cancer when it rises above the level of 4 nanograms per milliliter
(ng/mL) of blood.
The
investigators found that men who had PSA levels above the
group's average levels -- but still considered within normal
range -- were three to four times more likely to develop prostate
cancer within the coming decades.
The
average PSA level was 0.6 ng/mL for men in their 40s and 0.7
ng/mL for men in their 50s.
These results suggest that the process
of developing prostate cancer begins sometime in early middle
age.
Men with elevated levels of PSA may have
an increased sensitivity to "male," or androgen,
hormones, which increases their risk of prostate cancer. We
all inherit a different ability to use and metabolize hormones.
Those who use them more effectively may be at greater risk.
The American Cancer Society and the American
Urological Association recommend that men begin having PSA
tests to check for prostate cancer at age 50. In light of
these findings it appears men may benefit from having their
PSA levels tested earlier.
The author believes PSA should be tested
at age 40 and 45, and then every other year at age 50. Men
who are in their 40s who have levels below one range should
be looked at more carefully than those who have maintained
low levels.
Urology
September 2001;58:411-416
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