Systematic review and meta-analysis of the diagnostic accuracy of prostate-specific antigen (PSA) for the detection of prostate cancer in symptomatic patients.
dc.contributor.author | Merriel, SWD | |
dc.contributor.author | Pocock, L | |
dc.contributor.author | Gilbert, E | |
dc.contributor.author | Creavin, S | |
dc.contributor.author | Walter, FM | |
dc.contributor.author | Spencer, A | |
dc.contributor.author | Hamilton, W | |
dc.date.accessioned | 2022-07-22T08:39:51Z | |
dc.date.issued | 2022-02-07 | |
dc.date.updated | 2022-07-21T10:30:23Z | |
dc.description.abstract | BACKGROUND: Prostate-specific antigen (PSA) is a commonly used test to detect prostate cancer. Attention has mostly focused on the use of PSA in screening asymptomatic patients, but the diagnostic accuracy of PSA for prostate cancer in patients with symptoms is less well understood. METHODS: A systematic database search was conducted of Medline, EMBASE, Web of Science, and the Cochrane library. Studies reporting the diagnostic accuracy of PSA for prostate cancer in patients with symptoms were included. Two investigators independently assessed the titles and abstracts of all database search hits and full texts of potentially relevant studies against the inclusion criteria, and data extracted into a proforma. Study quality was assessed using the QUADAS-2 tool by two investigators independently. Summary estimates of diagnostic accuracy were calculated with meta-analysis using bivariate mixed effects regression. RESULTS: Five hundred sixty-three search hits were assessed by title and abstract after de-duplication, with 75 full text papers reviewed. Nineteen studies met the inclusion criteria, 18 of which were conducted in secondary care settings with one from a screening study cohort. All studies used histology obtained by transrectal ultrasound-guided biopsy (TRUS) as a reference test; usually only for patients with elevated PSA or abnormal prostate examination. Pooled data from 14,489 patients found estimated sensitivity of PSA for prostate cancer was 0.93 (95% CI 0.88, 0.96) and specificity was 0.20 (95% CI 0.12, 0.33). The area under the hierarchical summary receiver operator characteristic curve was 0.72 (95% CI 0.68, 0.76). All studies were assessed as having a high risk of bias in at least one QUADAS-2 domain. CONCLUSIONS: Currently available evidence suggests PSA is highly sensitive but poorly specific for prostate cancer detection in symptomatic patients. However, significant limitations in study design and reference test reduces the certainty of this estimate. There is very limited evidence for the performance of PSA in primary care, the healthcare setting where most PSA testing is performed. | en_GB |
dc.description.sponsorship | Cancer Research UK | en_GB |
dc.description.sponsorship | National Institute for Health Research | en_GB |
dc.format.extent | 54- | |
dc.format.medium | Electronic | |
dc.identifier.citation | Vol. 20, article 54 | en_GB |
dc.identifier.doi | https://doi.org/10.1186/s12916-021-02230-y | |
dc.identifier.grantnumber | C8640/A23385 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/130333 | |
dc.identifier | ORCID: 0000-0003-2919-9087 (Merriel, Samuel WD) | |
dc.identifier | ORCID: 0000-0002-8163-3103 (Spencer, Anne) | |
dc.identifier | ORCID: 0000-0003-1611-1373 (Hamilton, Willie) | |
dc.identifier | ScopusID: 55031252700 | 57209301809 (Hamilton, Willie) | |
dc.identifier | ResearcherID: G-8612-2014 (Hamilton, Willie) | |
dc.language.iso | en | en_GB |
dc.publisher | BMC | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/35125113 | en_GB |
dc.rights | © The Author(s). 2022 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | en_GB |
dc.subject | Diagnostic accuracy | en_GB |
dc.subject | LUTS | en_GB |
dc.subject | Lower urinary tract symptoms | en_GB |
dc.subject | PSA | en_GB |
dc.subject | Primary care | en_GB |
dc.subject | Prostate cancer | en_GB |
dc.subject | Prostate-specific antigen | en_GB |
dc.subject | Secondary care | en_GB |
dc.title | Systematic review and meta-analysis of the diagnostic accuracy of prostate-specific antigen (PSA) for the detection of prostate cancer in symptomatic patients. | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2022-07-22T08:39:51Z | |
exeter.article-number | 54 | |
exeter.place-of-publication | England | |
dc.description | This is the final version. Available from BMC via the DOI in this record. | en_GB |
dc.description | Availability of data and materials: All data were extracted from published research articles. The study protocol is available on PROSPERO and database search strategy is attached as an additional file. | en_GB |
dc.identifier.eissn | 1741-7015 | |
dc.identifier.journal | BMC Medicine | en_GB |
dc.relation.ispartof | BMC Med, 20(1) | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2021-12-30 | |
dc.rights.license | CC BY | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2022-02-07 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2022-07-22T08:37:02Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2022-07-22T08:40:08Z | |
refterms.panel | A | en_GB |
refterms.dateFirstOnline | 2022-02-07 |
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The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the
data made available in this article, unless otherwise stated in a credit line to the data.