title: Prostate cancer screening parameters in a high-risk African-Caribbean population.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA.
authors.forename: Clareann H
authors.initials: CH
authors.lastname: Bunker
authors.forename: Alan L
authors.initials: AL
authors.lastname: Patrick
authors.forename: Iva
authors.initials: I
authors.lastname: Miljkovic-Gacic
authors.forename: Badrinath R
authors.initials: BR
authors.lastname: Konety
authors.forename: Andrew
authors.initials: A
authors.lastname: Belle
authors.forename: Jean Robert
authors.initials: JR
authors.lastname: Richard
authors.forename: Rajiv
authors.initials: R
authors.lastname: Dhir
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D044383:Black People / Q000208:ethnology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D010173:Palpation; D011237:Predictive Value of Tests; D015995:Prevalence; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D014300:Trinidad and Tobago / Q000208:ethnology; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen