From the Guidelines
The reference range for prostate-specific antigen (PSA) varies by age, with the most recent and highest quality study providing age-specific reference ranges for serum PSA levels. For adults, the typical PSA reference ranges are as follows:
- 40–49 years: 0–2.0 ng/mL for Asian-Americans and African-Americans, and 0–2.5 ng/mL for Whites 1
- 50–59 years: 0–3.0 ng/mL for Asian-Americans, 0–4.0 ng/mL for African-Americans, and 0–3.5 ng/mL for Whites 1
- 60–69 years: 0–4.0 ng/mL for Asian-Americans, 0–4.5 ng/mL for African-Americans, and 0–4.5 ng/mL for Whites 1
- 70–79 years: 0–5.0 ng/mL for Asian-Americans, 0–5.5 ng/mL for African-Americans, and 0–6.5 ng/mL for Whites 1 It is essential to consider these age-specific reference ranges when interpreting PSA values, as they reflect normal physiological changes in prostate function throughout life. Additionally, factors like digital rectal examination (DRE) findings and individual risk factors can influence what's considered normal for an individual, so clinical context should always be considered when interpreting PSA values 1.
Some studies suggest that men at high risk, including men of African descent and men with a first-degree relative diagnosed with prostate cancer before age 65, should begin testing at age 45, with annual testing recommended if PSA is greater than 1.0 ng/mL but less than 2.5 ng/mL 1. However, the most recent and highest quality study provides the age-specific reference ranges mentioned earlier, which should be prioritized when interpreting PSA values 1.
In clinical practice, it is crucial to consider the benefits and limitations of testing for early detection and treatment of early-stage prostate cancer, as well as the potential harms associated with testing and treatment 1. Therefore, the reference range for PSA should be interpreted in the context of individual patient risk factors, clinical findings, and age-specific reference ranges.
Key points to consider when interpreting PSA values include:
- Age-specific reference ranges for serum PSA levels
- Individual risk factors, such as family history and ethnicity
- Digital rectal examination (DRE) findings
- Clinical context and potential benefits and limitations of testing and treatment.
From the Research
Tag Reference Range by Age
There are no specific studies provided that directly address the topic of tagging reference ranges by age. However, some studies discuss the interpretation of laboratory values and the importance of considering age-related factors.
- The study by 2 discusses the interpretation of pediatric laboratory values, including the complete blood count (CBC) with differential and liver function tests (LFTs), highlighting the need to consider age-related factors in laboratory interpretation.
- Other studies, such as 3, 4, and 5, focus on the use of CBC and other laboratory tests in various clinical settings, but do not specifically address the topic of tagging reference ranges by age.
- The study by 6 discusses the concept of external validity, generalisability, and applicability in the context of evidence-based medicine, which may be relevant to considering age-related factors in laboratory interpretation, but does not directly address the topic of tagging reference ranges by age.
Laboratory Tests and Age-Related Factors
Some laboratory tests, such as CBC, may have age-related reference ranges. For example:
- The study by 2 mentions that normal laboratory parameters and rationale for deviations from normal are reviewed, implying that age-related factors may be considered in laboratory interpretation.
- The study by 5 introduces the red blood cell test components of the CBC, which may have age-related reference ranges, but does not specifically discuss tagging reference ranges by age.