Baseline PSA Predicts Long-term Prostate Cancer Risk

This post is courtesy of the Cleveland Clinic. . .

A recent study involving Cleveland Clinic researchers suggests that baseline prostate specific antigen (PSA) levels in middle age can predict the long-term risk of clinically significant prostate cancer and be used to determine subsequent screening intervals.

The study included 10,968 men, ages 55 to 60, who underwent PSA testing as part of a major prostate cancer screening trial.

During a 13-year follow-up period, the incidence of clinically significant prostate cancer ranged from 0.4% among men with PSA levels less than 0.49 nanograms per milliliter (ng/mL) to 5.4% among those with PSA values of 1.0 to 1.99 ng/mL.

The incidence rate jumped to 10.6% for men with PSA levels between 2 and 2.99 ng/mL and to 29.5% for PSA values of 4 ng/mL or higher.

The findings suggest that middle-aged men with PSA values of between 1 and 1.99 ng/mL could undergo less intensive screening than men with higher levels, while those with values below 1 ng/mL could potentially discontinue screening, the researchers wrote (JAMA Network Open, Jan. 15, 2020).

The take-home message (according to this article): Baseline PSA values in middle age may predict your long-term risk of clinically significant prostate cancer. Talk to your physician about the pros and cons of prostate cancer screening, as well as an appropriate screening interval based on your baseline PSA value.

Cancer Journeys Foundation Thoughts on Baseline PSA Testing*

  • Having a baseline PSA test to establish your potential future prostate cancer risk makes sense
  • The PSA test isn’t perfect but it is affordable, widely available, and currently is the gold standard for early detection
  • Aggressive prostate cancer tends to come early in life, so CJF recommends a baseline PSA test at 40, followed by annual tests to detect any increase from the previous YEAR (any increase should be discussed with your doctor or medical care professional)
  • Men should personally track their annual PSA test
  • The CJF provides a free online PSA tracking service at
  • Beating prostate cancer means finding it early
  • Just Do It®

* The Cancer Journeys Foundation does not provide medical advice. If you have any questions concerning prostate cancer and testing, please contact your doctor or medical service provider.

Ben Stiller credits his baseline PSA test at 46 with saving his life.

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