Prostate cancer (prostate cancer) is the fifth leading cause of cancer mortality among men worldwide. Early detection of localized disease leads to an almost 100% 5-year survival rate. The definition of biomarkers is currently popular as additional tools that allow you to determine the tactics of management. The aim to evaluate the clinical significance of PSA-associated tests in the diagnosis of localized prostate cancer and benign prostatic hyperplasia in patients with senile asthenia syndrome. Material and methods. The study included 897 men with prostate pathology who were being treated at the I.I.Pavlov State Medical University. All patients were diagnosed with mild and moderate severity of senile asthenia (the index "Age is not a hindrance" from 1 to 4 points). The markers of prostate cancer and BPH were studied: free PSA (svPSA), p2PSA, [-2]proPSA, its percentage ratio to the total PSA (%svPSA, %[-2]proPSA), as well as the density of OPS and svPSA (the ratio of the corresponding PSA fraction to the volume of the pancreas) was calculated. Results. The probability of detecting local prostate cancer according to the results of the determination of SVPs was 39%, and the probability of rejecting the diagnosis in the absence of changes was 74%. The index of the overall accuracy of the diagnosis of prostate cancer in determining the density of OPS was 61.2%. The probability of detecting local prostate cancer based on the results of determining the % of SVPs was 4%, and the probability of rejecting the diagnosis in the absence of changes was 10% compared to its absolute concentration. The index of the overall accuracy of the diagnosis of prostate cancer in determining the density of OPS was 45.0%. The probability of detecting local prostate cancer based on the results of p2PSA determination was 52.4%, and the probability of rejecting the diagnosis in the absence of changes was 67.5%. Changes in the combination of the two tests with BPH were 60% less common compared to BPH, the absence of changes – with BPH was 30% less common compared to BPH. The index of the overall accuracy of the diagnosis of prostate cancer in determining the density of OPS was 62.9%. However, the most significant differences were found in the determination of ISP, the average value of which was 49% higher in the case of BPH compared to BPH. The most informative indicators for the diagnosis of prostate cancer were ISP, as well as [-2]proPSA, whereas for BPH – svPSA. Conclusion. The use of PSA-associated tests taking into account the age of patients is a promising direction, as it can increase the diagnostic value of the analysis result and avoid "unnecessary" biopsies.