The proportion of false-positives in positive Seratec® prostate-specific antigen SemiQuant test results in postmortem...

Prostate-specific antigen (PSA) tests are used in forensics to conduct rapid screening for semen in vaginal swab samples from alleged victims of sexual abuse. Although PSA membrane tests have been applied to autopsy specimens, no study has evaluated predictors of false-positive test results in relation to factors such as age, cause of death, postmortem interval, drugs, and alcohol. This study describes the results obtained with the Seratec® PSA SemiQuant Kit test in 283 deceased women, with or without a history of sexual assault. Overall, 18.4% (52/283) of the vaginal swab samples tested positive for PSA. However, 63.5% (33/52) of the PSA-positive vaginal swab samples had no sperm detected. The proportion of false-positives in positive PSA results was 94.4% in those aged over 60 years. Multivariate logistic regression for PSA-positive samples showed that the proportion of false-positives in positive PSA results increased with the age of the deceased. However, the cause of death, postmortem interval, and presence of drugs or alcohol in the blood or urine of the deceased did not affect the PSA determination. These results show that PSA membrane tests are relatively unreliable and can be misleading, especially when derived from vaginal swab samples of older women, obtained at autopsy. In forensic cases, positive PSA screening test results may have an impact on subsequent legal actions and criminal charges brought against the accused. These findings are important for both forensic pathologists and the police to ensure accurate screening of older women in cases of suspected sex crimes.