The Value of Age-adjusted Prostate Specific Antigen Density (AAPSAD) Helps to Avoid Unnecessary Biopsies in Men with Intermediate Serum PSA Levels

Abstract

Purpose: Prostate biopsies were performed usually in patients with intermediate Prostate Specific Antigen (PSA) levels, however cancer detection rate was low. We would like to reduce unnecessary biopsies by developing a new PSA formula for determining cancerous conditions of the prostate. Materials and Methods: We retrospectively enrolled 99 patients with intermediate serum PSA levels. The patients were divided into two groups, the prostate cancer group (19 patients) and the benign disease group (80 patients). We developed a new formula to calculate the age-adjusted PSA density (AAPSAD), and applied it to both groups. In addition, we compared the efficacy of AAPSAD in detecting prostate cancer in men with intermediate PSA levels, compared with other PSA parameters. Results: The prostate cancer patients had higher AAPSAD than non-prostate cancer patients (p=0.000). The sensitivity, and specificity, of AAPSAD were 94.7% and 60.0%, respectively at a cut-off level of 0.6, and higher than those obtained for the Prostate Specific Antigen Density (PSAD), PSA density of the transitional zone (PSA-TZ) and free to total PSA ratio (F/T PSA ratio). Conclusions: We suggest that the use of AAPSAD, in patients with intermediate PSA levels, may be helpful, not only to detect prostate cancer, but also to reduce unnecessary prostate biopsies.