ABSTRACT

Introduction: A common biomarker for the early identification of prostate diseases, including prostate cancer, is prostate-specific antigen (PSA) testing. But benign disorders like benign prostatic hyperplasia (BPH) can also cause an increase in PSA levels, which can result in diagnostic conundrums and needless biopsies. A PSA cutoff of 4.0 ng/mL is widely utilized worldwide, although not all age groups or demographics may benefit from this set level. Since PSA levels are known to be influenced by age and prostate volume, a number of studies indicate that setting age-specific PSA reference ranges may improve diagnostic precision and lower overdiagnosis. Redefining PSA rules to suit local demography is becoming more and more necessary in the Indian setting, where there is a lack of population-based and region-specific data. This study aimed to establish age-specific PSA reference ranges and examine theirassociation with Prostate Volume (PV) in a North Karnataka population to enhance diagnostic accuracy and minimize unnecessary biopsies. Methodology: Conducted in a tertiary care hospital, 130 non-malignant BPH cases were analyzed. Results: The mean PSA increased with age, with 95th percentile values ranging from 1.03 ng/mL (41–50 years) to 5.2 ng/mL (81–90 years). Compared to other Indian and global studies, our findings reinforce the need for region-specific PSA thresholds. Notably, a strong and highly significant positive correlation was found between prostate volume and PSA levels, indicating that prostate size substantially contributes to PSA elevation in men without prostate cancer. Conclusion: Age and prostate volume significantly influence PSA levels in men without prostate cancer. Establishing age-specific, region-based PSA reference ranges can improve diagnostic accuracy. This approach may help reduce unnecessary biopsies in benign prostate conditions. Prostate volume-adjusted PSA reference ranges might enhance clinical judgment. Keywords: Prostate-Specific Antigen (PSA), Prostate Volume, Benign Prostatic Hyperplasia (BPH), Age-specific reference range, Non-malignant prostate conditions, Indian population
Publication date: 01/06/2026

https://www.ijbpas.com/pdf/2026/June/MS_IJBPAS_2026_10222.pdf

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https://doi.org/10.31032/IJBPAS/2026/15.6.10222