10 minute consultation: High result in prostate specific antigen test

Abstract Background Being diagnosed with cancer, irrespective of type initiates a serious psychological concern. The increasing rate of detection of indolent prostate cancers is a source of worry to public health. Digital rectal examination and prostate-specific antigen tests are the commonly used prostate cancer screening tests. Understanding the diagnostic accuracies of these tests may provide clearer pictures of their characteristics and values in prostate cancer diagnosis. This review compared the sensitivities and specificities of digital rectal examination and prostate-specific antigen test in detection of clinically important prostate cancers using studies from wider population. Main body We conducted literature search in PubMed, Medline, Science Direct, Wiley Online, CINAHL, Scopus, AJOL and Google Scholar, using key words and Boolean operators. Studies comparing the sensitivity and specificity of digital rectal examination and prostate-specific antigen tests in men 40 years and above, using biopsy as reference standard were retrieved. Data were extracted and analysed using Review manager (RevMan 5.3) statistical software. The overall quality of the studies was good, and heterogeneity was observed across the studies. The result comparatively shows that prostate-specific antigen test has higher sensitivity (P < 0.00001, RR 0.74, CI 0.67–0.83) and specificity (P < 0.00001, RR 1.81, CI 1.54–2.12) in the detection of prostate cancers than digital rectal examination. Conclusion Prostate-specific antigen test has higher sensitivity and specificity in detecting prostate cancers from men of multiple ethnic origins. However, combination of prostate-specific antigen test and standardized digital rectal examination procedure, along with patients history, may improve the accuracy and minimize over-diagnoses of indolent prostate cancers.

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Occupation as a predictor of prostate cancer screening behaviour in Canada

Journal of Medical Screening ◽

10.1177/0969141320902485 ◽

2020 ◽

Vol 27 (4) ◽

pp. 215-222

Author(s):

Cheryl E Peters ◽

Paul J Villeneuve ◽

Marie-Élise Parent

Keyword(s):

Prostate Cancer ◽

Cancer Screening ◽

Prostate Specific Antigen ◽

Prostate Cancer Screening ◽

Specific Antigen ◽

Digital Rectal Examination ◽

Antigen Test ◽

Screening Practices ◽

Rectal Examination ◽

Prostate Specific Antigen Test

Objectives If prostate cancer screening practices relate to occupation, this would have important implications when studying the aetiological role of workplace exposures on prostate cancer. We identified variations in screening by occupation among men in Montreal, Canada (2005–2012). Methods Prostate specific antigen testing and digital rectal examination (ever-screened and frequency of screening, previous five years) were examined among population controls from the Prostate Cancer & Environment Study. Face-to-face interviews elicited lifestyle and occupational histories. Multivariable logistic regression was used to estimate the odds of ever-screening for the longest-held occupation, adjusting for potential confounders. Negative binomial models were used to examine relationships with screening frequency. Results Among 1989 controls, 81% reported ever having had a prostate specific antigen test, and 77% a digital rectal examination. Approximately 40% of men reported having a prostate specific antigen test once a year, on average. Compared with those in management or administrative jobs, men in primary industry (odds ratio 0.26, 95% confidence interval 0.10–0.65), construction (0.44, 0.25–0.79), machining (0.45, 0.21–0.97), and teaching (0.37, 0.20–0.70) were less likely to have undergone prostate specific antigen screening. Results were similar when considering the most recent job. Conclusions Our findings highlight substantial variations in prostate cancer screening by occupation. Men in occupations where carcinogen exposures are more common are less likely to participate in prostate screening activities. This could be an important source of bias, and occupational studies of prostate cancer should account for screening practices.

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