Midlife PSA tests may predict prostate cancer diagnosis up to 25 years later

Swedish researchers report that PSA levels measured at ages 44 to 50 may accurately predict which men will develop cancer up to 25 years later. Researchers at Lund University in Malmö, Sweden, analyzed blood samples originally collected from 1974 to 1986 as part of a heart disease study, and at a time when most men were not routinely screened with PSA tests. The researchers thawed 462 blood samples taken from men later diagnosed with prostate cancer, measured PSA, and then compared them with 1,222 thawed blood samples from controls without cancer. They found that prostate cancer risk increased about 3.7 times for each 1 ng/ml increase in PSA level.

Although PSA screening remains a controversial issue, this study suggests that all men may want to consider an initial PSA test between ages 45 and 50, to assess long-term risk of developing prostate cancer. Men whose tests indicate they are at low risk could then undergo only periodic follow-up PSA tests, while those at higher risk could undergo more frequent testing. But the researchers want to analyze the data further, and conduct follow-up studies, to determine how best to target screening efforts.

Source: Lilja H, Ulmert D, Bjork T, et al. Long-Term Prediction of Prostate Cancer up to 25 Years Before Diagnosis of Prostate Cancer Using Prostate Kallikreins Measured at Age 44 to 50 Years. Journal of Clinical Oncology 2007;25:431–6. PMID: 17264339.

Originally published April 2009;  last reviewed March 21, 2011.