Pre- and post-analytical factors that may influence use of serum prostate specific antigen and its isoforms in a screening programme for prostate cancer
Year: 2001
Type: review
Study design: Systematic Review
Abstract: In 1995 the Standing Group on Health Technology Assessment commissioned two systematic reviews on screening for prostate cancer. The authors of these reports concluded that, at the time of the writing, the evidence available did not support the introduction of a screening programme. The main reasons given for this conclusion were that: (1) the serum prostate speci®c antigen (PSA) test in observational studies had resulted in a number of false positives and false negatives; (2) there were concerns about the potential costs (®nancial, social and psychological) of a screening programme; (3) there were concerns about the clinical and cost-effectiveness of treatments for localized disease; and (4) there was a need to look for prognostic markers that would identify those tumours likely to progress more rapidly and hence require more active treatment. Furthermore, there were overall concerns about the quality of the studies undertaken to date. At the time of the reviews referred to earlier, serum PSA was the biochemical marker of choice for prostate malignancy. Older markers such as prostatic acid phosphatase had been dropped and other potential markers had not been suf®ciently well developed to warrant further consideration. Since that time it has been recognized that there are several isoforms of PSA in the circulation. Furthermore, there are new methods of assay calibration and a recognition that several pre-analytical factors may affect the circulating level of PSA. The present review was commissioned by a steering group of the National Screening Committee to assess the preand post-analytical issues surrounding the measurement of PSA; the ®ndings should be taken into account in any future proposals for the implementation of a screening programme. An electronic search was undertaken using Medline and Embase, supported by handsearching of the most relevant journals and review articles.
Institution: Queen Mary University of London
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2062906866