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March 9, 1994

Age-Specific Reference Ranges for Prostate-Specific Antigen-Reply

Author Affiliations

Mayo Clinic Rochester, Minn

JAMA. 1994;271(10):747. doi:10.1001/jama.1994.03510340036024

In Reply.  —Our study defines the clinically useful reference ranges for serum PSA concentration according to age, using standard, well-accepted methods.1,2 The so-called normal level for a given diagnostic marker should be established in a cohort of individuals with no clinical evidence of having the condition that the diagnostic marker is useful for detecting but who are at risk for developing it. For PSA the appropriate cohort is randomly chosen men between 40 and 79 years of age who have no evidence of prostate cancer by currently available diagnostic tests. When there is no clinically relevant lower limit for the diagnostic marker, the 95th percentile is used to determine the upper limit of the reference range. For PSA, these upper limits were found to be age-dependent and are as follows: 40 to 49 years of age, 2.5 ng/mL, and 70 to 79 years of age, 6.5 ng/mL. This increase