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Prostate cancer screening parameters in a high-risk African-Caribbean population

2004; Elsevier BV; Volume: 63; Issue: 4 Linguagem: Inglês

10.1016/j.urology.2003.10.064

1527-9995

Clareann H. Bunker, Alan L. Patrick, Iva Miljkovic, Badrinath R. Konety, Andrew Belle, Jean Robert Richard, Rajiv Dhir,

Global Cancer Incidence and Screening

Objectives To estimate the prostate cancer screening parameters in a population-based study of African-Caribbean men from the Island of Tobago. Methods A total of 2582 men aged 40 to 79 years (50% of all Tobago men in this age group) were screened using both serum prostate-specific antigen (PSA) and digital rectal examination (DRE). Men with an elevated PSA level (4 ng/mL or greater) or abnormal DRE findings were referred for ultrasound-guided sextant biopsy. Results The screening results for one or both tests were abnormal in 32% of men. The prevalence of prostate cancer was 10.7 of 100 screened men. The positive predictive value for PSA was 56% compared with 39% for DRE. The positive predictive value for PSA ranged from 6% for those aged 40 to 49 years to 59% for those aged 70 to 79 years. The sensitivity was 71% and the specificity 86% for DRE. The sensitivity for PSA was 80%. The sensitivity was low among men aged 40 to 49 years (20%) and 50 to 59 years (66%). The specificity for PSA declined across age groups from 98% for those aged 40 to 49 years to 70% for those 70 to 79 years. Conclusions The screening parameters in this African-Caribbean population were similar to the sparse data available from other populations of African descent. The screening was highly efficacious, with a positive predictive value of 56% for an elevated PSA level and 40% for an elevated PSA level and/or abnormal DRE findings.