World Journal of Urology

, Volume 28, Issue 6, pp 693–697

Has blood volume an impact on serum PSA levels?

  • Anton Ponholzer
  • Christian Temml
  • Stephan Madersbacher
Original Article



Prostate-specific antigen (PSA) is measured in circulating blood volume (BV), which is known to have a wide inter- and intraindividual variability. As data investigating the potential impact of different BV on PSA test validity are scant, we determined the relationship between BV and serum PSA values.


Men aged 41–60 years, participating in a health screening project, were evaluated. Serum samples of fasting patients were drawn between 8.00 and 10.00 a.m., all PSA measurements were determined in the same laboratory. Circulating BV was calculated according to the Retzlaff formula based on height, weight and haematocrit.


A total of 400 men with a mean age of 47.9 years entered the analysis. Mean PSA was 1.20 ng/ml (range 0.23–8.59 ng/ml) and mean BV was 3,370 ml (range 2,380–4,220 ml). Mean PSA values stratified from lowest to the highest third of BV were 1.22, 1.17 and 1.19 ng/ml in the total cohort. The respective figures for men aged 41–50 years were 1.08, 0.98 and 1.03 ng/ml, and for those aged 51–60 years: 1.47, 1.48 and 1.53 ng/ml. Neither BV nor three other related biometrical parameters (body mass index, waist–hip ratio, body fat percentage) revealed a correlation with the PSA values.


Our data suggest that BV does not have a significant impact on serum PSA values. To exclude a potential minor impact of BV on PSA, larger study cohorts, however, are required.


Tumour marker Validity Obesity Prostate cancer 


  1. 1.
    Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Copien DE, Yuan JJ, Petros JA, Andriole GL (1991) Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med 324:1156–1161CrossRefPubMedGoogle Scholar
  2. 2.
    Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E (1987) Prostate-specific antigen as a serum marker for adenocarcinoma for the prostate. N Engl J Med 317:909–916CrossRefPubMedGoogle Scholar
  3. 3.
    Loeb S, Catalona WJ (2007) Prostate-specific antigen in clinical practice. Cancer Lett 249:30–39CrossRefPubMedGoogle Scholar
  4. 4.
    Gonzalgo ML, Carter HB (2007) Update on PSA testing. J Natl Compr Canc Netw 5:737–742PubMedGoogle Scholar
  5. 5.
    Werny DM, Thompson T, Saraiya M, Freedman D, Kottiri BJ, German RR, Wener M (2007) Obesity is negatively associated with PSA in US men, 2001–2004. Cancer Epidemiol Biomarkers Prev 16:70–76CrossRefPubMedGoogle Scholar
  6. 6.
    Fowke JH, Signorelle LB, Chang SS, Matthews CE, Buchowski MS, Cookson MS, Ukoli FM, Blot WJ (2006) Effects of obesity and height on PSA and percentage of fPSA levels among African-American and Caucasian men. Cancer 107(10):2361–2367CrossRefPubMedGoogle Scholar
  7. 7.
    Baillargeon J, Pollock BH, Kristal AR, Bradshaw P, Hernandez J, Basler J, Higgins B, Lynch S, Rozansky T, Troyer D, Thompson I (2004) The association of BMI and PSA in a population-based study. Cancer 103(5):1092–1095CrossRefGoogle Scholar
  8. 8.
    Freedland SJ, Platz EA, Presti JC, Aronson WJ, Amling CL, Kane CJ, Terris MK (2006) Obesity, serum PSA and prostate size: implications for prostate cancer detection. J Urol 175:500–504CrossRefPubMedGoogle Scholar
  9. 9.
    Baraqawi AB, Golden BK, O’Donnell C, Brawer MK, Crawford ED (2005) Observed effect of BMI on tPSA and cPSA: analysis from a national screening program. Urology 65:708–712CrossRefGoogle Scholar
  10. 10.
    Ku JH, Kim ME, Lee NK, Park YH, Ahn JO (2003) Influence of age, anthropometry and hepatic and renal function on serum PSA levels in healthy middle-aged men. Urology 61:132–136CrossRefPubMedGoogle Scholar
  11. 11.
    Banez LJ, Hamilton RJ, Partin AW, Vollmer RT, Sun L, Rodriguez C, Wang Y, Terris MK, Aronson WJ, Presti JC, Kane CJ, Amling CL, Moul JW, Freedland SJ (2007) Obesity-related hemodilution and PSA concentration among men with prostate cancer. JAMA 298(19):2275–2280CrossRefPubMedGoogle Scholar
  12. 12.
    Grubb RL III, Black A, Izmirlian G, Hickey TP, Pinsky PF, Mabie JE, Riley TL, Ragard LR, Prorok PC, Berg CD, Crawford ED, Church TR, Andriole GL Jr., PLCO Project Team (2009) Serum PSA hemodilution among obese men undergoing screening in the prostate, lung, colorectal and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev 18:748–751CrossRefPubMedGoogle Scholar
  13. 13.
    Vollmer RT, Humphrey PA (2003) Tumor volume in prostate cancer and serum PSA: analysis from a kinetic viewpoint. Am J Clin Pathol 119(1):80–89CrossRefPubMedGoogle Scholar
  14. 14.
    Sprenger KBG, Huber K, Kratz W, Henze E (1987) Nomograms for the prediction of patients’ plasma volume in plasma exchange therapy from height, weight and hematocrit. J Clin Apher 3:185–190CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Anton Ponholzer
    • 1
  • Christian Temml
    • 2
  • Stephan Madersbacher
    • 1
  1. 1.Department of Urology and AndrologyDonauspital, SMZ-OstViennaAustria
  2. 2.Department of Preventive HealthCity of ViennaAustria

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