A systematic review of the diagnostic accuracy of prostate specific antigen.
A systematic review of the diagnostic accuracy of prostate specific antigen.
Harvey P, Basuita A, Endersby D, Curtis B, Iacovidou A, Walker M.
Conclusion
Implications for practice
PSA testing still has a role to play in the diagnostic pathway and is relatively non-invasive and inexpensive [19]. However it has a low specificity. Other tests, which could improve this, are currently being researched but have not been implemented into clinical practice. We recommend that PSA testing continues to be used in clinical practice as one of the several indicators for biopsy, but it is important that clinicians understand the limitations of the test. It would be interesting to assess the role of a PSA result in GPs’ decision making, for example the impact of the high false positive and significant false negative rates.
Implications for research
As our study was unable to assess specificity and sensitivity in the screening setting it would be useful for a review to examine this. Screening is especially relevant as programmes emerge. We would recommend that for further research done into PSA, the STARD statements be implemented to ensure standardisation and transparency. We recommend that further research includes a sub-analysis according to patients’ symptoms.