Prostate-specific antigen (PSA) reference ranges in Congolese men: a multicentric population-based study

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Abstract Background Prostate cancer (PCa) is the most common cancer among men in the Republic of the Congo. However, the lack of epidemiological and biological data specific to the local context limits the development of appropriate screening strategies. Given the central role of PSA testing in PCa screening, the establishment of local guidelines and recommendations appears essential. Objectives To establish prostate-specific antigen (PSA) reference ranges specific to Congolese men and to analyze the effect of age on PSA variability. Methods We conducted an analytical, cross-sectional, multicentric, and population-based study between 2023 and 2025 in seven cities in the Republic of the Congo. The sample included men aged 40 years and older. Standardized PSA testing was performed via fluorescence immunochromatography. PSA reference ranges were calculated at the 95th percentile. Results The mean age of the participants ( n = 1,536) was 62 (SD: 9) years. The median PSA concentration was 2.0 (IQR: 1.1) ng/mL. The PSA reference ranges (in ng/mL) were 0–3.34 for ages 40–49, 0–4.68 for ages 50–59, 0–6.64 for ages 60–69, 0–7.40 for ages 70–79, and 0–8.38 for ages over 80. There was a weak positive correlation between age and PSA ( r = 0.219; 95% CI [0.103–0.330]; p < 0.001). The difference in PSA was significant across age groups ( p < 0.001). The overall effect size of age groups on PSA levels was small (η² H = 0.025). Conclusion PSA reference ranges were established in this study. These findings may support the development and adaptation of PCa screening strategies in the Republic of the Congo.