Assessment and Modeling of the Relationship Between Age, Prostate Volume, and Prostate‐Specific Antigen in a Population of Men From Sub‐Saharan Africa With a Low Risk of Prostate Cancer

ABSTRACT PSA levels are influenced by several non‐tumor‐related factors, including age and prostate volume (PV). However, data on the relationships between these parameters in sub‐Saharan African populations remain limited. To assess and quantify the associations between age, PV, and PSA in Congolese men with a low probability of prostate cancer (PCa). This was a cross‐sectional analytical study. Participants aged 40 years and older who had undergone PSA testing and PV measurement were included. Participants with findings suggestive of PCa were excluded. Correlations were analyzed using Spearman's rank correlation coefficient. Natural log‐transformed linear regressions were used to estimate the relative changes in PV and PSA. A total of 622 participants were included. The median age was 62 (IQR: 14) years, the median PV was 40 (30) mL, and the median PSA was 2.0 (1.9) ng/mL. A weak positive correlation was observed between PSA and age ( ρ = 0.399, 95% CI: 0.328–0.465, p < 0.001), PSA and PV ( ρ = 0.278, 95% CI: 0.202–0.351, p < 0.001), and PV and age ( ρ = 0.303, 95% CI: 0.228–0.375, p < 0.001). Analysis by age group revealed significant differences in PV and PSA ( p < 0.001), with medium overall effect sizes for PV ( η 2 H = 0.096) and large effect sizes for PSA ( η 2 H = 0.205). In linear regression, the natural logarithm (ln) of PSA increased with age ( β = 0.024, 95% CI: 0.019–0.029, p < 0.001), corresponding to a relative increase of 27.1% per decade. The ln(PSA) also increased with PV ( β = 0.004, 95% CI: 0.002–0.006, p < 0.001), representing a relative increase of 4.1% for every 10 mL of PV. Finally, the ln(PV) increased with age ( β = 0.016, 95% CI: 0.012–0.020, p < 0.001), corresponding to a relative increase of 17.4% per decade. This study highlights a correlation between age, PV, and PSA in Congolese men with a low probability of PCa. These results underscore the importance of considering age and PV when interpreting PSA results.