Variables Associated with False-Positive PSA Results: A Cohort Study with Real-World Data

Area of Science:

• Urology
• Oncology
• Clinical Chemistry

Background:

• Real-world data on false-positive prostate-specific antigen (PSA) test results are lacking.
• Understanding factors influencing PSA test accuracy is crucial for clinical practice.

Purpose of the Study:

• To analyze clinical and analytical factors associated with false-positive PSA results in a real-world setting.
• To provide data for improved shared decision-making regarding PSA testing.

Main Methods:

• Prospective cohort study involving patients undergoing PSA testing in clinical practice.
• Medical records were reviewed for 2 years or until a prostate cancer diagnosis.

Main Results:

• The false-positive PSA rate was 46.8%, while the false-negative rate was 2.8%.
• Increased likelihood of false-positive PSA results was observed in patients aged 61-70 and over 70 years.
• Urinary tract infections significantly increased the odds of false-positive PSA results (aOR 8.42).
• Diabetes mellitus was associated with a decreased likelihood of false-positive PSA results (aOR 0.63).

Conclusions:

• This study provides critical real-world data on the incidence and predictors of false-positive PSA results.
• Findings can aid clinicians in interpreting PSA test results and discussing implications with patients.
• The high false-positive rate underscores the need for careful consideration of PSA test results in clinical decision-making.