PSA doubling time versus PSA velocity to predict high-risk prostate cancer: data from the Baltimore Longitudinal Study of Aging

Eur Urol. 2008 Nov;54(5):1073-80. doi: 10.1016/j.eururo.2008.06.076. Epub 2008 Jul 2.


Background: Our group has previously shown that prostate-specific antigen (PSA) velocity (PSAV) is associated with the presence of life-threatening prostate cancer. Less is known about the relative utility of pretreatment PSA doubling time (PSA DT) to predict tumor aggressiveness.

Objective: To compare the utility of PSAV and PSA DT for the prediction of life-threatening prostate cancer.

Design, setting, and participants: From the Baltimore Longitudinal Study of Aging, we identified 681 men with serial PSA measurements.

Measurements: Receiver operating characteristic analysis was used to evaluate the relationship between PSAV, PSA DT, and the presence of high-risk disease.

Results and limitations: Within the period of 5 yr prior to diagnosis, PSAV was significantly higher among men with high-risk or fatal prostate cancer than men without it. By contrast, PSA DT was not significantly associated with high-risk or fatal disease. On multivariate analysis, including age, date of diagnosis, and PSA, the addition of PSAV significantly improved the concordance index from 0.85 to 0.88 (p<0.001), whereas PSA DT did not.

Conclusions: These data suggest that PSAV is more useful than PSA DT in the pretreatment setting to help identify those men with life-threatening disease.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Baltimore / epidemiology
  • Biomarkers, Tumor / blood
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / epidemiology
  • ROC Curve
  • Risk Assessment / methods*
  • Risk Factors
  • Time Factors


  • Biomarkers, Tumor
  • Prostate-Specific Antigen