Prostate-specific antigen testing accuracy in community practice
<p>Abstract</p> <p>Background</p> <p>Most data on prostate-specific antigen (PSA) testing come from urologic cohorts comprised of volunteers for screening programs. We evaluated the diagnostic accuracy of PSA testing for detecting prostate cancer in community practice.&...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2002-10-01
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| Series: | BMC Family Practice |
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| Online Access: | http://www.biomedcentral.com/1471-2296/3/19 |
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| author | Adams-Cameron Meg Gilliland Frank D Hoffman Richard M Hunt William C Key Charles R |
| author_facet | Adams-Cameron Meg Gilliland Frank D Hoffman Richard M Hunt William C Key Charles R |
| author_sort | Adams-Cameron Meg |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Most data on prostate-specific antigen (PSA) testing come from urologic cohorts comprised of volunteers for screening programs. We evaluated the diagnostic accuracy of PSA testing for detecting prostate cancer in community practice.</p> <p>Methods</p> <p>PSA testing results were compared with a reference standard of prostate biopsy. Subjects were 2,620 men 40 years and older undergoing (PSA) testing and biopsy from 1/1/95 through 12/31/98 in the Albuquerque, New Mexico metropolitan area. Diagnostic measures included the area under the receiver-operating characteristic curve, sensitivity, specificity, and likelihood ratios.</p> <p>Results</p> <p>Cancer was detected in 930 subjects (35%). The area under the ROC curve was 0.67 and the PSA cutpoint of 4 ng/ml had a sensitivity of 86% and a specificity of 33%. The likelihood ratio for a positive test (LR+) was 1.28 and 0.42 for a negative test (LR-). PSA testing was most sensitive (90%) but least specific (27%) in older men. Age-specific reference ranges improved specificity in older men (49%) but decreased sensitivity (70%), with an LR+ of 1.38. Lowering the PSA cutpoint to 2 ng/ml resulted in a sensitivity of 95%, a specificity of 20%, and an LR+ of 1.19.</p> <p>Conclusions</p> <p>PSA testing had fair discriminating power for detecting prostate cancer in community practice. The PSA cutpoint of 4 ng/ml was sensitive but relatively non-specific and associated likelihood ratios only moderately revised probabilities for cancer. Using age-specific reference ranges and a PSA cutpoint below 4 ng/ml improved test specificity and sensitivity, respectively, but did not improve the overall accuracy of PSA testing.</p> |
| first_indexed | 2024-04-13T15:05:15Z |
| format | Article |
| id | doaj.art-2a301ce812f54a0da1ba3324f30535d9 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-13T15:05:15Z |
| publishDate | 2002-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-2a301ce812f54a0da1ba3324f30535d92022-12-22T02:42:10ZengBMCBMC Family Practice1471-22962002-10-01311910.1186/1471-2296-3-19Prostate-specific antigen testing accuracy in community practiceAdams-Cameron MegGilliland Frank DHoffman Richard MHunt William CKey Charles R<p>Abstract</p> <p>Background</p> <p>Most data on prostate-specific antigen (PSA) testing come from urologic cohorts comprised of volunteers for screening programs. We evaluated the diagnostic accuracy of PSA testing for detecting prostate cancer in community practice.</p> <p>Methods</p> <p>PSA testing results were compared with a reference standard of prostate biopsy. Subjects were 2,620 men 40 years and older undergoing (PSA) testing and biopsy from 1/1/95 through 12/31/98 in the Albuquerque, New Mexico metropolitan area. Diagnostic measures included the area under the receiver-operating characteristic curve, sensitivity, specificity, and likelihood ratios.</p> <p>Results</p> <p>Cancer was detected in 930 subjects (35%). The area under the ROC curve was 0.67 and the PSA cutpoint of 4 ng/ml had a sensitivity of 86% and a specificity of 33%. The likelihood ratio for a positive test (LR+) was 1.28 and 0.42 for a negative test (LR-). PSA testing was most sensitive (90%) but least specific (27%) in older men. Age-specific reference ranges improved specificity in older men (49%) but decreased sensitivity (70%), with an LR+ of 1.38. Lowering the PSA cutpoint to 2 ng/ml resulted in a sensitivity of 95%, a specificity of 20%, and an LR+ of 1.19.</p> <p>Conclusions</p> <p>PSA testing had fair discriminating power for detecting prostate cancer in community practice. The PSA cutpoint of 4 ng/ml was sensitive but relatively non-specific and associated likelihood ratios only moderately revised probabilities for cancer. Using age-specific reference ranges and a PSA cutpoint below 4 ng/ml improved test specificity and sensitivity, respectively, but did not improve the overall accuracy of PSA testing.</p>http://www.biomedcentral.com/1471-2296/3/19Prostatic neoplasmsprostate-specific antigensensitivity and specificityROC curvelikelihood functions |
| spellingShingle | Adams-Cameron Meg Gilliland Frank D Hoffman Richard M Hunt William C Key Charles R Prostate-specific antigen testing accuracy in community practice BMC Family Practice Prostatic neoplasms prostate-specific antigen sensitivity and specificity ROC curve likelihood functions |
| title | Prostate-specific antigen testing accuracy in community practice |
| title_full | Prostate-specific antigen testing accuracy in community practice |
| title_fullStr | Prostate-specific antigen testing accuracy in community practice |
| title_full_unstemmed | Prostate-specific antigen testing accuracy in community practice |
| title_short | Prostate-specific antigen testing accuracy in community practice |
| title_sort | prostate specific antigen testing accuracy in community practice |
| topic | Prostatic neoplasms prostate-specific antigen sensitivity and specificity ROC curve likelihood functions |
| url | http://www.biomedcentral.com/1471-2296/3/19 |
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