From the Guidelines
For a 68-year-old male, an acceptable PSA rise is generally considered to be less than 1.0 ng/mL per year, as recommended by Bhasin et al. and supported by the study 1. This concept, known as PSA velocity, is an important monitoring tool for prostate health. If your PSA increases by more than 1.0 ng/mL in a year, it warrants further evaluation by your healthcare provider, though it doesn't necessarily indicate cancer. The absolute PSA level is also important - for men without prostate cancer, PSA levels typically increase gradually with age, with 4.0 ng/mL often used as a general threshold for further investigation. However, individual baseline values matter significantly. If your previous PSA was 1.0 ng/mL and jumps to 3.0 ng/mL in a year, this 2.0 ng/mL increase would be concerning despite remaining below the 4.0 threshold. Regular annual PSA testing is recommended for men your age to establish your personal pattern and detect significant changes. Other factors like prostatitis, recent ejaculation, or certain medications can temporarily affect PSA levels, so these should be discussed with your doctor when interpreting results. It's also worth noting that the American College of Physicians recommends that clinicians inform men between the age of 50 and 69 years about the limited potential benefits and substantial harms of screening for prostate cancer, as stated in the study 1. The goal is to balance the potential benefits of early detection with the potential harms of screening and treatment, and to make informed decisions based on individual patient preferences and values. In terms of specific guidance, the study 1 suggests that a yearly PSA increase of 1.0 ng/mL or more should prompt a prostate biopsy, while a PSA increase of 0.7 to 0.9 ng/mL in one year should lead to a repeat PSA measurement in three to six months, with biopsy considered if there is any further increase. Ultimately, the decision to screen for prostate cancer and how to interpret PSA results should be made in consultation with a healthcare provider, taking into account individual patient factors and preferences.
From the Research
Acceptable Rise in PSA Yearly
- The acceptable rise in PSA yearly for a 68-year-old male is not explicitly stated in the provided studies, but some studies provide information on PSA velocity.
- A study published in JAMA in 2003 2 found that a PSA velocity higher than 0.75 ng/mL per year was considered abnormal.
- This suggests that a yearly rise in PSA of more than 0.75 ng/mL may be considered unacceptable, but this value may vary depending on individual factors and should be interpreted in the context of other clinical evaluations, such as digital rectal examination (DRE) and prostate biopsy results.
- Other studies focus on the detection of prostate cancer using PSA and DRE, but do not provide specific guidance on acceptable yearly PSA rises 3, 4, 5, 6.