title: Routine estimation of prostate specific antigen prior to clinic attendance in patients with symptoms of bladder outlet obstruction.
abstract: We report the use of serum prostate specific antigen (PSA) estimations prior to clinic attendance in 234 patients referred with symptoms of bladder outlet obstruction to a general urology clinic. Ninety-three patients with PSA levels > 10 ng/ml were seen earlier than planned and offered transurethral resection or transrectal biopsy of the prostate gland. Forty-six patients (49%) proved to have carcinoma of the prostate, compared with 10 of 141 (7%) patients who had PSA values < 10 ng/ml. With a decision value of 10 ng/ml, the sensitivity for detecting carcinoma was 82% and specificity 73.5%. Using a decision value of 7 ng/ml improved the sensitivity to 95% without significantly affecting the specificity (70%). Twenty-four patients with prostatic cancer had bone metastases; the sensitivity of PSA for predicting a positive bone scan using a decision value of 25 ng/ml was 92%, but the specificity was only 31%.
authors.affiliation: Department of Urology, Broadgreen Hospital, Liverpool.
authors.forename: S
authors.initials: S
authors.lastname: Viswanath
authors.forename: M A
authors.initials: MA
authors.lastname: Palmer
authors.forename: H O
authors.initials: HO
authors.lastname: Ojha
authors.forename: A D
authors.initials: AD
authors.lastname: Desmond
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000150:complications / Q000276:immunology; D012680:Sensitivity and Specificity; D014524:Urethral Obstruction / Q000097:blood* / Q000209:etiology
chemical_list: D017430:Prostate-Specific Antigen