1. According to UpToDate…”The traditional cutoff for an abnormal PSA level in the major screening studies has been 4.0 ng/mL .The American Cancer Society systematically reviewed the literature assessing PSA performance. In a pooled analysis, the estimated sensitivity of a PSA cutoff of 4.0 ng/mL was 21 percent for detecting any prostate cancer and 51 percent for detecting high-grade cancers (Gleason ≥8). Using a cutoff of 3.0 ng/mL increased these sensitivities to 32 and 68 percent, respectively. The estimated specificity was 91 percent for a PSA cutoff of 4.0 ng/mL and 85 percent for a 3.0 ng/mL cutoff. ” Use the prevalence rate of 6% for men over 60 yo.
Please construct two 2×2 tables for a PSA of 3.0 ng and 4.0 ng to detect a high-grade lesion. Then calculate the PPV & NPV use a sample size of 1000, clearly state the sensitivity and specificity for each, and share your thoughts on the test- would YOU use it?
