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Published on: November 17, 2023
[Correct use of prostate-specific antigen in office practice]
F-R Desfemmes1, E Deligne, O Ghoundale
1Service d'Urologie, Hôpital d'Instruction des Armées du Val-de-Grâce, 74, boulevard Port-Royal, 75005 Paris, France. fre.desfemmes@neuf.fr <fre.desfemmes@neuf.fr>
Summary
Diverse prostate-specific antigen (PSA) testing methods and interpretations by clinical laboratories create confusion for doctors and patients. Standardization is needed for accurate PSA assay results and clinical decision-making.
Area of Science:
- Clinical Pathology
- Biochemistry
Background:
- Prostate-specific antigen (PSA) assays are crucial for prostate cancer screening and management.
- Variability in laboratory practices can impact the accuracy and interpretation of PSA results.
Purpose of the Study:
- To standardize the interpretation and reporting of prostate-specific antigen (PSA) assay results from clinical pathology laboratories in office settings.
- To identify inconsistencies in PSA testing methodologies and result interpretation.
Main Methods:
- Retrospective analysis of PSA assay results from 100 diverse laboratories between September 2004 and May 2006.
- Examination of PSA assay kits, interpretation of total PSA values, and analysis of free PSA/total PSA ratios.
Main Results:
- Nineteen different PSA assay kits were identified.
- A "normal" total PSA value below 4 ng/ml was used by two-thirds of the kits.
- Free PSA/total PSA ratio cut-offs varied from 10% to 25%, with comments more frequently referencing benign prostatic hyperplasia than prostate cancer.
Conclusions:
- Significant diversity in PSA assay techniques and interpretation guidelines exists among laboratories.
- This lack of standardization leads to interpretation challenges for both healthcare providers and patients.
- Standardized protocols are essential for reliable PSA testing and improved patient care.
