What is the age‑adjusted normal range for prostate‑specific antigen in a 72‑year‑old man?

Normal PSA Range for a 72-Year-Old Male

For a 72-year-old man, the normal PSA reference range is 0-6.5 ng/mL for white men, 0-5.5 ng/mL for African-American men, and 0-5.0 ng/mL for Asian-American men, with a median value of approximately 1.5 ng/mL for men in their 70s. 1, 2

Age-Specific Reference Ranges by Ethnicity

The American Urological Association provides clear age-adjusted PSA reference ranges that account for the natural increase in PSA with aging 1:

For men aged 70-79 years:

• White men: 0-6.5 ng/mL 1, 2
• African-American men: 0-5.5 ng/mL 1, 2
• Asian-American men: 0-5.0 ng/mL 1, 2

Understanding the Median Value

The median PSA for men in their 70s is 1.5 ng/mL, which serves as a more clinically relevant benchmark than the upper limit of normal 1, 2. This means that half of healthy 72-year-old men without prostate cancer have PSA values below 1.5 ng/mL, making values significantly above this median more concerning even if they fall within the "normal" range 1.

Clinical Context and Interpretation

When PSA is Below 3.0 ng/mL

Men aged 75 years or older with PSA less than 3.0 ng/mL are unlikely to die from prostate cancer and may safely discontinue screening 2, 3. At age 72, a PSA below 3.0 ng/mL represents very low risk 3.

When PSA is 3.0-6.5 ng/mL

Values in this range warrant individualized assessment based on:

• PSA velocity: For men over 70, a rise of 0.75 ng/mL per year is concerning and requires at least three PSA values over 18 months to calculate accurately 1, 2
• Digital rectal examination findings: An abnormal DRE is an independent indication for further evaluation regardless of PSA level 2
• Overall health status and life expectancy: Men with less than 10 years of life expectancy are unlikely to benefit from prostate cancer detection 2, 3

When PSA is Above 6.5 ng/mL

Values exceeding the age-specific reference range require confirmation with repeat testing using the same laboratory assay, as PSA variability can range from 20-25% 1, 2. After confirmation, further evaluation with multiparametric MRI and potential biopsy should be considered if the patient has adequate life expectancy 2.

Important Caveats for Accurate Interpretation

Factors that can elevate PSA without cancer present:

• Benign prostatic hyperplasia (BPH), which is extremely common at age 72 1
• Prostatitis or urinary tract infection 1
• Recent prostate biopsy (wait 3-6 weeks before testing) 1
• Ejaculation (though effects are variable and often insignificant) 1

Factors that can lower PSA:

• Finasteride or dutasteride therapy lowers PSA by approximately 50% 1

Laboratory considerations:

• Always use the same laboratory and assay for serial measurements, as assays are not interchangeable 1, 2
• Assays using the WHO standard yield results 20-25% lower than those using the Hybritech standard 1, 2

Screening Considerations at Age 72

The benefit-to-harm ratio of PSA screening decreases substantially after age 70 3. Very few men older than 75 years benefit from PSA testing, and routine screening substantially increases rates of overdetection 3. At age 72, screening decisions should prioritize whether detection and treatment would meaningfully improve mortality or quality of life given overall health status 3.