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Prostate Specific Antigen—a Screening Test for Prostatic Cancer?
Author(s) -
POWELL C. S.,
FIELDING A. M.,
ROSSER K.,
AMES A. C.,
VAUGHTON K. C.
Publication year - 1989
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1989.tb05287.x
Subject(s) - medicine , prostatic acid phosphatase , prostatism , urology , prostate , prostate specific antigen , prostate cancer , cancer , gynecology , carcinoma , prostate cancer screening , biopsy , oncology , prostate disease
Summary— A series of 287 patients referred by their family doctors with symptoms of bladder outflow obstruction were asked to attend the hospital for “pre‐clinic” screening for carcinoma of prostate (CaP). Blood samples were collected from 211 patients and analysed for serum prostate specific antigen (PSA) and prostatic acid phosphatase (PAP). Thirty‐six patients had a serum PSA > 10 μg/l and 7 had PAP levels > 5 iu/l. In no instance was the PAP elevated without an associated increase in PSA concentration. Patients with raised markers underwent further investigations which included prostatic biopsy and/or resection; 17 patients were proved to have carcinoma of the prostate, 9 of whom had distant metastases. The specificity of PSA for detecting prostate cancer in this study was 90% with a sensitivity of 89.5%, in contrast to values for PAP of 100% and 36.8%. The routine use of PAP as a marker for prostatic cancer should be abandoned. The use of PSA as a screening test in a group of patients with prostatism appears justified, but with a positive predictive value of only 47%, its use in a mass unselected screening programme is not recommended.