The Prostatic Imperative and the Social Relations of Medical Technology

1997 ◽  
Vol 13 (4) ◽  
pp. 602-612 ◽  
Author(s):  
Evan Willis
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Social Relations ◽  
Technology Assessment ◽  
Medical Technology ◽  
Specific Antigen ◽  
Specific Reference ◽  
Sociological Approach ◽  
Psa Testing ◽  
The Social

AbstractA sociological approach to medical technology assessment is outlined in this paper, first in general and then with specific reference to controversies surrounding the use of prostate-specific antigen (PSA) testing to population screening for prostate cancer.

Trends in Prostate Specific Antigen (PSA) testing and prostate cancer incidence and mortality in Australia: A critical analysis

2022 ◽  
Vol 77 ◽  
pp. 102093
Author(s):  
Thanya Pathirana ◽  
Rehan Sequeira ◽  
Chris Del Mar ◽  
James A. Dickinson ◽  
Bruce K. Armstrong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Cancer Incidence ◽  
Critical Analysis ◽  
Specific Antigen ◽  
Prostate Cancer Incidence ◽  
Psa Testing ◽  
Incidence And Mortality

AGE-SPECIFIC REFERENCE RANGES FOR PROSTATE-SPECIFIC ANTIGEN-BASED DETECTION OF PROSTATE CANCER IN BLACK MEN

1996 ◽  
Vol 89 (Supplement) ◽  
pp. S131
Author(s):  
Ted O. Morgan ◽  
Steven J. Jacobsen ◽  
William F. McCarthy ◽  
David G. McLeod ◽  
Judd W. Moul
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Black Men ◽  
Specific Antigen ◽  
Specific Reference ◽  
Reference Ranges

scholarly journals PSA screening for prostate cancer

2017 ◽  
Vol 63 (8) ◽  
pp. 722-725 ◽  
Author(s):  
Marcus V. Sadi
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Early Diagnosis ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Low Grade ◽  
Psa Screening ◽  
Psa Testing ◽  
Baseline Values

Summary Screening of prostate cancer with prostate-specific antigen (PSA) is a highly controversial issue. One part of the controversy is due to the confusion between population screening and early diagnosis, another derives from problems related to the quality of existing screening studies, the results of radical curative treatment for low grade tumors and the complications resulting from treatments that affect the patient’s quality of life. Our review aimed to critically analyze the current recommendations for PSA testing, based on new data provided by the re-evaluation of the ongoing studies and the updated USPSTF recommendation statement, and to propose a more rational and selective use of PSA compared with baseline values obtained at an approximate age of 40 to 50 years.

The role of prostate specific antigen measurement in the detection and management of prostate cancer.

2000 ◽  
pp. 37-51 ◽  
Author(s):  
A F Nash ◽  
I Melezinek
Keyword(s):  
Prostate Cancer ◽  
Endocrine Therapy ◽  
Prostate Specific Antigen ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Marked Change ◽  
Reference Ranges ◽  
Psa Density ◽  
Psa Testing

The introduction of prostate specific antigen (PSA) testing has revolutionised the early detection, management and follow-up of patients with prostate cancer and it is considered to be one of the best biomedical markers currently available in the field of oncology. Its use with annual digital rectal examination in prostate cancer screening programmes has led to a marked change in the distribution of stage at presentation towards earlier disease and led to a significant increase in the detection of potentially curable disease. In order to improve the specificity of PSA testing and thereby reduce the number of unnecessary prostatic biopsies, a number of refinements of PSA evaluation have been proposed. These include free to total PSA ratio, PSA density, PSA density, PSA density of the transition zone, PSA velocity and age-specific PSA reference ranges. The utility of these approaches is considered in this review. The role of PSA monitoring in the detection of recurrence following radical prostatectomy and radiotherapy is discussed, as well as its role in monitoring patients treated with endocrine therapy is discussed, as well as its role in monitoring patients treated with endocrine therapy in terms of correlating PSA response with outcome, in detecting disease progression and in guiding the use of subsequent therapies. Large continuing multicentre screening and outcome studies will provide important information enabling greater refinement of the use of this important diagnostic and monitoring tool in the future detection and management of prostate cancer.

scholarly journals Systematic Review & Meta-Analysis of the Diagnostic Accuracy of Prostate Specific Antigen (PSA) for the Detection of Prostate Cancer in Symptomatic Patients

2021 ◽  
Author(s):  
Samuel William David Merriel ◽  
Lucy Pocock ◽  
Emma Gilbert ◽  
Sam Creavin ◽  
Fiona M Walter ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Prostate Specific Antigen ◽  
Meta Analysis ◽  
Specific Antigen ◽  
Database Search ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Reference Test ◽  
Psa Testing

Abstract BackgroundProstate 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.MethodsA 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.Results563 search hits were assessed by title and abstract after de-duplication, with 75 full text papers reviewed. 19 studies met the inclusion criteria, 18 of which were conducted in secondary care settings (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 receiving-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.ConclusionsCurrently available evidence suggests PSA is highly sensitive but poorly specific for prostate cancer detection. 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.

Prostate-specific antigen and biomarkers for prostate cancer

2017 ◽  
Author(s):  
Hans Lilja
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Opportunistic Screening ◽  
High Risk Prostate Cancer ◽  
Psa Testing ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer ◽  
Prostatic Diseases ◽  
Significant Disease

Prostate-specific antigen (PSA) is a kallikrein serine protease secreted by the prostate to liquefy the ejaculatory coagulum. Changes in the blood/prostate barrier allows PSA to enter the circulation in men with prostate cancer and other inflammatory prostatic diseases. The commonest method for detection of men at risk of prostate cancer is PSA testing, which is typically used in an opportunistic screening setting. The widespread use of PSA testing leads to overdiagnosis and overtreatment of many men with low-risk prostate cancer, but can allow the identification of those with significant disease requiring radical treatment. This lack of specificity for high-risk prostate cancer has led to the need for more accurate biomarkers or methods to improve the use of PSA testing.

scholarly journals The Prostate Gland and PSA (Prostate Specific Antigen)

2016 ◽  
Vol 2 (2) ◽  
pp. 74
Author(s):  
Serfa Faja ◽  
Amir Shoshi
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Quantitative Measurement ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
High Sensitivity ◽  
Psa Test ◽  
Psa Testing ◽  
Very High

The PSA test is used primarily to screen for prostate cancer. A PSA test measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced in the prostate, a small gland that sits below a man's bladder. PSA is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood. The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels. We use ImmunoAssay for Quantitative Measurement of PSA in Human Blood / Serum / Plasma with i-CHROMA TM Reader System with high sensitivity and specifity. We have analysed 120 patients and only 2 of them had very high value of PSA so we can determine for a prostate cancer. Additional factors increase the accuracy of PSA testing and it is not sufficient only the PSA to determine a prostate cancer so we need a rectal examination and transrectal ultrasound.

Age-Specific Reference Ranges for Prostate-Specific Antigen as a Marker for Prostate Cancer

2007 ◽  
Vol 5 (1) ◽  
pp. 38-48 ◽  
Author(s):  
Hans-Joachim Luboldt ◽  
Joachim F. Schindler ◽  
Herbert Rübben
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Specific Reference ◽  
Reference Ranges

Prostate-specific antigen testing among primary care physicians and urologists: Patterns of care and impact of professional society guidelines.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 40-40
Author(s):  
Sandip M. Prasad ◽  
G. Caleb Alexander ◽  
Scott E. Eggener
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Specific Antigen ◽  
Primary Care Physicians ◽  
Medical Condition ◽  
Specific Antigen ◽  
The United States ◽  
Chronic Medical Condition ◽  
The Past ◽  
Psa Testing

40 Background: During the past decade, the incidence of prostate cancer in the United States has declined. We hypothesized this was related to lower rates of prostate-specific antigen (PSA) testing and sought to evaluate PSA testing rates nationally. Methods: Using the National Ambulatory Medical Care Survey, a nationally representative sample of outpatient visits in the United States, we analyzed rates of PSA testing in men age 40 years or older who visited PCPs or urologists from 1997 to 2008. Results: An estimated 26.6 million (95% CI: 24.8-28.4 million) PSA tests were ordered during 94.5 million (95% CI: 90.9-98.1 million) office visits to urologists and 95 million (95% CI: 87.5-102.8 million) tests were ordered during 1.17 billion (95% CI: 1.15-1.18 billion) visits to PCPs, with an annual increase of 3.4% and 6.0%, respectively (P=0.055 and P<0.001 for trend). After adjusting for year, race, ethnicity, region, insurance and provider type, testing by PCPs was more likely among older men and highest among men aged 60 to 69 years (reference: 40-49 years; OR 2.32, 95% CI: 1.88-2.85). Compared to men without a chronic medical condition, those with one chronic condition had greater odds of receiving a PSA test (OR 1.28, 95% CI: 1.08-1.52). Conclusions: Prostate cancer incidence has declined over the past decade despite increasing rates of office-based PSA testing by PCPs and urologists during the period. Increasing rates of PSA testing merit scrutiny, especially in men with limited life expectancies who are unlikely to benefit from screening.

scholarly journals PSA testing in general practice

2012 ◽  
Vol 4 (3) ◽  
pp. 199 ◽  
Author(s):  
Fraser Hodgson ◽  
Zuzana Obertová ◽  
Charis Brown ◽  
Ross Lawrenson
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Age Groups ◽  
Psa Test ◽  
Psa Screening ◽  
Psa Testing ◽  
Asymptomatic Patients ◽  
Keywords Prostate ◽  
General Practices

INTRODUCTION: In New Zealand, prostate-specific antigen (PSA) testing has increased significantly (275 000 tests/year). Controversy exists around PSA testing as part of an unorganised screening programme. AIM: To look at the use of PSA testing in a sample of general practices and investigate the reasons GPs undertake PSA testing. METHODS: Five Waikato general practices investigated looking at PSA laboratory tests of men =40 years in 2010 compared against GP notes. Testing rates, reasons for testing, histology and referral/s were examined for different age groups. A questionnaire was sent to the GPs to determine their views on PSA testing. RESULTS: One in four men aged 40+ years had a PSA test in 2010. Of these men, 71% were asymptomatic. More than half of men tested aged 70+ years were asymptomatic. Ten percent of all PSA tests were elevated. Twenty-one of 23 prostate cancers were diagnosed following an elevated PSA test: more than 80% of these men had histories of prostate pathology or lower urinary tract symptoms. The questionnaire confirmed that GPs believe in the benefits of PSA screening and it also showed they had difficulty in providing patients with information about pros and cons of PSA testing. DISCUSSION: All GPs in this study tested asymptomatic men. GPs in this study value PSA screening and believe that it reduces mortality rates. However, although PSA tests were most frequently done on asymptomatic patients, the majority of patients subsequently diagnosed with prostate cancer had been tested because of symptoms or had previous prostate problems. KEYWORDS: Prostate specific antigen (PSA); PSA testing; screening; prostate cancer; general practitioners

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