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Diagnostic accuracy of prostate-specific antigen below 4 ng/mL as a cutoff for diagnosing prostate cancer in a hospital setting: A systematic review and meta-analysis

A prostate-specific antigen (PSA) cutoff of 4 ng/mL has been widely used for prostate cancer screening in population-based settings. However, the accuracy of PSA below 4 ng/mL as a cutoff for diagnosing prostate cancer in a hospital setting is inconclusive. We systematically reviewed the accuracy of...

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Bibliographic Details
Published in:Investigative and clinical urology 2022, 63(3), , pp.251-261
Main Authors: Jin, Yan, Jung, Jae Hung, Han, Woong Kyu, Hwang, Eu Chang, Nho, Yoonmi, Lee, Narae, Yun, Ji Eun, Lee, Kwang Suk, Lee, Sang Hyub, Lee, Hakmin, Yu, Su-Yeon
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Language:English
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Summary:A prostate-specific antigen (PSA) cutoff of 4 ng/mL has been widely used for prostate cancer screening in population-based settings. However, the accuracy of PSA below 4 ng/mL as a cutoff for diagnosing prostate cancer in a hospital setting is inconclusive. We systematically reviewed the accuracy of PSA below 4 ng/mL cutoff in a hospital setting. We systematically reviewed the literature by searching major databases until March 2020, and a meta-analysis and quality assessment were performed. A total of 11 studies were included at the completion of the screening process. The meta-analysis showed a sensitivity of 0.92 and a specificity of 0.16 for a PSA cutoff below 4 ng/mL. The area under the hierarchical summary receiver operating characteristic curve was 0.87, the positive likelihood ratio was 1.23, the negative likelihood ratio was 0.46, and the diagnostic odds ratio was 2.64. PSA sensitivities and specificities varied according to the cutoff range: 0.94 and 0.17 for 2 to 2.99 ng/mL, and 0.92 and 0.16 for 3 to 3.99 ng/mL, respectively. No significant differences in the sensitivity and specificity of PSA cutoffs in the range of 2 to 2.99 ng/mL and 3 to 3.99 ng/mL were found. Although a PSA cutoff
ISSN:2466-0493
2466-054X
2466-054X
DOI:10.4111/icu.20210429