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Related Experiment Videos

Prostate-specific antigen testing accuracy in community practice.

Richard M Hoffman1, Frank D Gilliland, Meg Adams-Cameron

  • 1Department of Medicine, New Mexico VA Health Care System, Albuquerque, New Mexico, USA. rhoffman@unm.edu

BMC Family Practice
|October 26, 2002
PubMed
Summary

Prostate-specific antigen (PSA) testing shows fair accuracy for prostate cancer detection in community settings. Adjusting PSA cutpoints or using age-specific ranges improves some metrics but not overall diagnostic power.

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Area of Science:

  • Urology
  • Oncology
  • Diagnostic Accuracy

Background:

  • Most prostate-specific antigen (PSA) testing data originate from urologic cohorts of screening volunteers.
  • This study assesses PSA testing's diagnostic accuracy in a community practice setting.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of PSA testing for prostate cancer detection in community practice.
  • To compare PSA testing results with prostate biopsy as the reference standard.

Main Methods:

  • 2,620 men aged 40+ underwent PSA testing and biopsy between 1995-1998 in Albuquerque, NM.
  • Diagnostic accuracy was measured using ROC curves, sensitivity, specificity, and likelihood ratios.

Main Results:

  • Prostate cancer was detected in 35% of subjects.

Related Experiment Videos

  • A PSA cutpoint of 4 ng/ml yielded 86% sensitivity and 33% specificity (AUC=0.67).
  • Age-specific ranges and lower PSA cutpoints improved individual metrics but not overall accuracy.

    • Conclusions:

    • PSA testing demonstrates fair discriminating power for prostate cancer in community practice.
    • The 4 ng/ml PSA cutpoint is sensitive but not highly specific; likelihood ratios offer moderate probability revision.
    • While age-specific ranges and lower cutpoints can enhance sensitivity or specificity, they do not improve overall PSA test accuracy for prostate cancer detection.