Total, free, and complexed prostate-specific antigen levels among US men, 2007-2010

Background: Screening for prostate cancer using prostate-specific antigen (PSA) is common. Prostate cancer has been associated with higher total PSA (tPSA), lower free PSA (fPSA), lower percent free PSA (MPSA), and higher complexed PSA (cPSA). Methods: Total, free and complexed PSAs were performed on 3251 men 40 years in the 2007-2010 National Health and Nutrition Examination Survey. Distributions of the PSA tests were examined by age, race and ethnicity, and body mass index (BMI) groups. Percentages of men at PSA thresholds were examined. Results: Total PSA geometric mean was 0.96 mu g/l among men aged >= 40 years and increased from 0.741 mu g/l for men 40-49 years, to 1.82 mu g/l for men 80 years and older. Non-Hispanic Whites had lower age-adjusted mean tPSA (1.03 mu g/l) and cPSA (0.56 mu g/l) than non-Hispanic Blacks (tPSA 1.25 mu g/l and cPSA 0.72 mu g/l). Obese men had lower age-adjusted mean total, free and complexed PSAs (0.94, 0.27, and 0.51 mu g/l, respectively) than men with normal BMI (tPSA 1.21, fPSA 0.32, and cPSA 0.68 mu g/l, respectively). Conclusion: Total, free and complexed PSAs increased with age; tPSA and cPSAs were highest in non-Hispanic Blacks; and total, free, and complexed PSAs were lowest in obese men. Published by Elsevier B.V.