Dear Colleagues,

RE: Change to PSA reporting cut offs

We will be making some changes to our age-related reference intervals for PSA to bring these in alignment with NICE guidance (https://cks.nice.org.uk/topics/prostate-cancer/diagnosis/psa-testing/ [1]). 

This guidance states that if the prostate specific antigen level in men of any race aged 50-69 is 3.0 ng/ml (ug/L) or higher, to refer these men urgently using a suspected cancer pathway referral (for an appointment within 2 weeks) to a specialist. 

The East of England Cancer Alliance has also mandated this change, with PSA reference cut offs for other age groups having been revised after discussion with local prostate cancer leads.

Age (years)	Current PSA reference intervals (ug/L)	New PSA cut offs (ug/L)
0 to 49	<2.5	<2.5
50 to 59	<3.5	<3.0
60 to 69	<4.5	<3.0
70 to 79	<6.5	<5.0
80+	<6.5	<10.0

 

We would like to remind colleagues that a new finding of a raised PSA must be confirmed with a repeat sample in 4 weeks.

Referral is recommended when there are two raised PSA results (in the absence of urinary tract infection and recent ejaculation).

Patients with a PSA result equal to, or greater than 10.0ug/L, should be immediately referred to Urology without the need for a repeat PSA test.

The respective clinical leads for the CCG have approved this clinical change, with an implementation date of 15/02/2021.

 

If you have any queries relating to this change please contact the Biochemistry Department on 01733 678455 or email peh-tr.ChemImm@nhs.net [2].

Kind regards,

Dr Mark Lum (Consultant Chemical Pathologist) and Jamie West (Biochemistry Manager)