Skip to content
Medical InsightsKoreaMedical Insights Korea

Prostate

What a Korean prostate looks like at 50, 60, 70 and 80. Twenty years of community screening put numbers on it

Prostate volume rises from 24.7 to 33.7 grams across three decades while peak flow falls from 20 to 13.8 mL/s. The sample is large, and it is not a random sample of Korean men.

Reported by

Reporter

Sources
1 cited
Published
Reading time
6 minutes

In short

In 72,068 Korean men over 50 examined through free community prostate health programmes run across all regions from 2001 to 2022, mean prostate volume rose from 24.7 g in the fifties to 27.7 g in the sixties, 31 g in the seventies and 33.7 g at 80 or above; mean International Prostate Symptom Score rose from 10.7 to 12.7, 14.5 and 16; mean maximum urinary flow fell from 20 to 17.4, 15.4 and 13.8 mL/s; and the proportion with a PSA above 3 ng/mL rose from 3.8 to 7.7, 13.1 and 17.9 percent, with 27.3 percent of all men reporting severe symptoms and 51.7 percent moderate ones.

Key takeaways

  • The Korean Prostate & Voiding Health Association surveyed 72,068 men older than 50 in community programmes across every region of Korea between 2001 and 2022.
  • Mean prostate volume by decade: 24.7 g (50s), 27.7 g (60s), 31 g (70s), 33.7 g (80+).
  • Mean International Prostate Symptom Score by decade: 10.7, 12.7, 14.5, 16.
  • Mean maximum urinary flow rate by decade: 20, 17.4, 15.4, 13.8 mL/s.
  • PSA above 3 ng/mL: 3.8 percent (50s), 7.7 percent (60s), 13.1 percent (70s), 17.9 percent (80+).
  • Across the whole sample, 27.3 percent reported severe symptoms and 51.7 percent moderate symptoms.
  • Overall means were 30.6 ± 15.1 g for volume, 14.8 ± 8.2 for IPSS, 1.9 ± 4.7 ng/mL for PSA and 15.6 ± 6.5 mL/s for peak flow.

Men told their prostate is enlarged rarely get told what the alternative would have been. Korean reference figures exist, they come from an unusually long collection effort, and they are worth reading with their sampling in mind.

Twenty-one years of community clinics

The Korean Prostate & Voiding Health Association ran free prostate health programmes with local public health centres in every region of the country from 2001 to 2022. Men over 50 were examined with history taking, the International Prostate Symptom Score, transrectal ultrasonography, PSA testing and uroflowmetry. 72,068 were analysed.

Korean men over 50, by decade of age
50s60s70s80+
Prostate volume24.7 g27.7 g31 g33.7 g
IPSS (symptom score)10.712.714.516
Peak urinary flow20 mL/s17.4 mL/s15.4 mL/s13.8 mL/s
PSA above 3 ng/mL3.8%7.7%13.1%17.9%

Every measure moves in the direction ageing predicts, and the size of the movement is the useful part. Prostate volume rises by roughly a third across three decades. Peak flow falls by nearly a third over the same span. Those two changes are not independent, but they are not the same change either, and a man with a 31-gram prostate and a normal flow rate is in a different position from one with the same gland and a flow of 13.

Who walked into these clinics

That does not weaken the figures for the purpose most patients need them for. A man sitting in a urology clinic is, by definition, a man who presented. The reference points that matter to him are the ones drawn from people in the same position, and this is the largest Korean set of them.

The number that is easiest to misread

PSA above 3 ng/mL reached 17.9 percent in men aged 80 and over. That is not a cancer rate. PSA rises with prostate volume, with inflammation and with age on its own, and in a cohort where mean volume is 33.7 grams a raised value is the expected consequence of a large gland. The overall mean PSA was 1.9 ng/mL with a standard deviation of 4.7 — a spread far wider than the mean, which is the signature of a small number of very high values sitting in an otherwise low distribution.

What the figure supports is the unglamorous point that an isolated PSA number carries less information in an older man with a large prostate than the same number would in a younger man with a small one. What it does not support is reading a threshold as a diagnosis.

Sources

  1. 1

    Jeh S, Choi M, Kang C, Kim D, Choi J, Choi S, Hwa J, Lee C, Kam S, Kwon S, et al.

    The epidemiology of male lower urinary tract symptoms associated with benign prostatic hyperplasia: Results of 20 years of Korean community care and surveys

    Investigative and Clinical Urology 2024;65(1):69-76

    doi:10.4111/icu.20230249 · PMID:38197753

    https://doi.org/10.4111/icu.20230249