Presentation Authors: Mineyuki Kato*, Koji Okihara, Yoshinori Marunaka, Osamu Ukimura, Kyoto, Japan
Introduction: Objectives of this study is to evaluate the natural history of PSA-change by age using the big data over 260,000 men in Japanese population which have been collected in the health-management service by Kyoto Industrial Health Association.
Methods: Between 2007 and 2017, a total of 263,073 men participated a medical health examination including PSA screening test conducted by Kyoto Industrial Health Association in Kyoto, Japan. Of those, we excluded the men who had already diagnosed with prostate cancer and who had continued prostate cancer treatment. The histogram of PSA value per each age were prepared and PSA slope-curves were developed to demonstrate the 25%, median (50%), 75%, 90%, or 95% value of PSA in each age. The age ranged from 16 to 98 years (median, 54 years). The total number of the men with 16-39, 40-49, 50-59, 60-69, and 70-98 years were 29,283, 52,900, 107,742, 58,736, and 13,978, respectively.
Results: The total number of examinees excluding the clinically diagnosed prostate cancer was 262,639. The median (50%) PSA of the age group of 40s, 50s, and 60s was 0.72, 0.80, and 0.97 ng/ml, respectively. Fig 1 showed the PSA slope-curves for 25, 50, 75, 90, and 95 percentiles of PSA value by age, respectively. Although the PSA slope-curves showed a steep rise after age of 45 years, such sharp rise was especially recognized in the curve of 75, 90, and 95 percentiles, but not in that of 25 and 50 percentiles. When the 90 or greater percentile of PSA value was defined as possible high-risk group for clinically significant cancer or development of high-volume prostate hypertrophy, we found the cut-off value for PSA-velocity in age-range of 40-49 was 0.034ng/ml/year. When we focused on the 50 percentile of PSA value in order to find the natural history of PSA velocity, we found the significant difference in comparison between average PSA velocity in age-range of 50s, vs. 60s were 0.01 vs. 0.07 ng/ml/year (p < 0.0001).
Conclusions: The natural history of PSA change in Japanese population were demonstrated with analyzing of a big data from 16 to 98 years old. This big data analysis could suggest the risk percentile for clinical prostate cancer or development of prostate hypertrophy as well as PSA velocity by age in Japanese population.