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J Urol. 2001 Dec;166(6):2189-91; discussion 2191-2.

Validity of the prostate specific antigen test for prostate cancer screening: followup study with a bank of 21,000 sera in Finland.

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  • 1Department of Public Health, Helsinki University, Tampere University School of Public Health, Finnish Cancer Registry, University Hospital of Helsinki, The National Public Health Institute, Helsinki, Finland.

Abstract

PURPOSE:

We investigate the validity of prostate specific antigen (PSA) as a screening test for prostate cancer.

MATERIALS AND METHODS:

A registry of serum samples drawn from 1968 to 1976 from 21,387 men was linked to the Finnish Cancer Registry. During followup from 1968 to 1991, 104 prostate cancers were identified. A matched case control design with incidence density sampling and nested in the serum sample bank was applied, and PSA was assessed.

RESULTS:

The estimated sensitivity of the test was 44% and specificity 94% at a cutoff of 4.0 microg./l. in the total material. The sensitivity had improved to 86% in patients diagnosed in 5 years after the sample drawing. The test had a better sensitivity (93%) and specificity (96%) in men younger than 65 years at the time of the sample drawing compared to those older. The sensitivity further improved to 100% with a cutoff of 2.5 microg./l.

CONCLUSIONS:

PSA is a valid screening test for prostate cancer, which compares favorably with mammography for breast cancer. However, until an effect on mortality has been shown, routine screening cannot be recommended.

PMID:
11696733
[PubMed - indexed for MEDLINE]
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