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PSA level OK for 37 yr old?

  Because my father died from Prostate cancer at age 62, and much
  cancer in my family, so my physician orders PSA tests during
  annual physicals.  I also get PSA results during annual
  screenings where I work.  I believe my doctor and employer each
  use different lab for blood work (one of two major hospitals
  in my area).
  my physician       annual screening (thru employer)
  -------------      ----------------
  Feb 96 - 1.84      
  Mar 97 - 1.90      Oct 97 - 2.12
  Feb 98 - 1.75      Oct 98 - 2.68
  Should I be concerned with 2.68 level at my age? (37)
  My doctor did DRE during 97 and said my prostate was almost
  normal, maybe slightly larger than normal. I have no problems
  with urination.  Are the frequent tests I'm doing just confusing
  the issue?  Is it common to get different results when working
  with two different labs?
  Thanks for any advice,
Dear Dan, Normally we do not recommend PSA testing before 40 years of age even in those who have positive family history or are of African American race.  Having said that, it should be realized that these recommendations must be individualized and tailored to a specific patient.  You already have had multiple serum PSA tests.   The normal age specific range is as follows:
< 49 years 0.0 to 2.5 ng/mL
50 years to 59 years 0.0 to 3.5 ng/mL
60 years to 69 years 0.0 to 4.5 ng/mL
70 years to 79 years 0.0 to 6.5 ng/mL
Your PSA is slightly more than your age specific range.  The other issue is that of rapid rise in PSA in last 6 months (0.93 ng in 6 months).  This is also higher than the norm, which is <0.7 ng/mL/year.  Based on these two findings I think you need further evaluation (there are no set norms for evaluation patients like you).  
Your urologist may like to perform a few additional tests such as free/complex PSA and check for any evidence of infection in the urine.  Finally if nothing else is found, you will need transrectal ultrasound guided needle biopsy of the prostate.  Further management plans will depend upon the findings of the biopsy.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
The Henry Ford Hospital Department of Urology has experience in the evaluation and treatment of problems such as you describes. They would be most interested in helping you. You can reach them through our toll-free number (1-800-653-6568). We can also arrange local accommodations through this number if this is your need.
*keyword: Prostate cancer

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