Prostate specific antigen for screening for prostate cancer: an appraisal of Thai reports

Prostate cancer is the most common cancer in male populations in many parts of the world. It is a slowing growing deadly cancer with very few signs and symptoms in the early stage. For screening, prostate specific antigen (PSA) has been proposed as a marker in the serum. It is widely employed in western countries, but use of PSA for prostate cancer screening in developing Asian countries is not generalized. Here, the author performed an appraisal on the diagnostic properties of serum PSA in screening prostate cancer among the Thais. Four reports from the literature were recruited for further metanalysis of a total of 1,321 cases. The overall diagnostic activity with regard to sensitivity, specificity, false positive and false negative rates, values being 95.8 %, 66.2 %, 33.8 % and 4.2 %, respectively. Therefore the test has good sensitivity, and sufficiently good diagnostic properties for screening when compared to digital rectal examination (DRE). However, serum PSA cannot be used for a definitive diagnosis, for which pathological confirmation is also necessary.