The sensitivity and specificity of the total prostate specific antigen test in prostate cancer screening: A Short report
Abstract Objective: The total prostate specific antigen (TPSA) test is still widely used in Ghana for PCa screening due to its simplicity and logistical challenges in the healthcare sector. This study aimed to determine the sensitivity and specificity of TPSA in PCa screening in Ghana. Results: This was a cross-sectional study that was conducted at the Department of Urology of the Komfo Anokye Teaching Hospital between January 2018 and December 2019. The study involved 69 male patients with histologically confirmed BPH or PCa. The study population was between 45 to 104 years. BPH patients constituted 74% (51/69) while 26% (18/69) were PCa patients. Venous blood samples were collected before the prostate examination and analysed for TPSA. The BPH group was statistically compared with the PCa group in terms of age and TPSA levels. The TPSA was significantly elevated in PCa (P=0.001). Univariate [OR: 8.684(1.757-42.927)] and multivariate [aOR:10.544(2.001-55.562)] analysis showed that TPSA was positively associated with PCa; but this association was only moderate (AUC:0.78, P<0.001) with a sensitivity of 83.3%, specificity 64.0% at a cut-off value of 20.0ng/ml. The TPSA test has only moderate performance in PCa screening and should always be complemented by a second screening test.