The influence of age on prostate cancer screening index

PURPOSE: This study aimed to identify parameters with a higher diagnostic value for early screening of prostate cancer (PCa) at different ages. MATERIALS AND METHODS: A total of 294 patients were included and divided into two groups according to the age of patients (≤66 and >66 years). Receiver operating characteristic (ROC) curves of total prostate‐specific antigen (TPSA), free PSA (FPSA), (F/T)PSA, PSA density (PSAD), PSA–AV score, the ratio of patients' age to prostate volume (AVR) and (F/T)/PSAD were constructed. The area under the ROC curve (AUC) was calculated, and differences in the AUC values among the above‐mentioned parameters were compared. RESULTS: There were 121 patients in the ≤66 years age group (benign prostatic hyperplasia BPH, 103 patients; PCa 18 patients) and 173 patients in the >66 years age group (BPH, 100 patients; PCa, 73 patients). In the ≤66 years age group, the AUC value of AVR for PCa diagnosis was the highest; however, there was no statistically significant difference compared with the AUC values of PSAD and (F/T)/PSAD; compared with TPSA, FPSA, (F/T)PSA and PSA‐AV, the differences were statistically significant. In the >66 years age group, the AUC values of PSAD and PSA–AV for PCa diagnosis were higher than those of TPSA, FPSA, (F/T)PSA and (F/T)/PSAD, and the difference was statistically significant; however, the difference was not statistically significant when compared with the AUC value of AVR. CONCLUSION: In different age groups, screening indices for PCa diagnosis should be selected according to the age of patients.