Sensitivity and specificity of prostate-specific antigen and its surrogates towards the detection of prostate cancer in sub-Saharan Africa: a systematic review with meta-analysis

African Journal of Urology

Table 2 Characteristics of studies examining the sensitivity and specificity of PSA

Authors	Age Mean (SD)	%fPSA Cut-off	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Prevalence (%)	Country	PCa Event/ Sample size	Design
Ezenwa et al. 2012 [12]	64.4 (6.6)	< 10	7.14	100	100	Nr	13.3	Nigeria	14/105	Prosp.
		< 15	35.7	100	100
		< 20	57.1	98.9	88.9
		< 25	78.6	97.8	84.6
		< 30	85.7	96.7	80.0
Tijani et al. 2017 [26]	64.05 (6.75)	≤ 10	43.2	92	62	85	21.9	Nigeria	37/167	Prosp.
		≤ 15	76	76	47	92
		≤ 20	100	45	34	100
		≤ 25	100	27	28	100
		≤ 30	100	16	25	100
Phiri-Ramongane & Khine, 2018 [28]	65.9 (7.3)	10	26	81	24	82	21.4	South Africa	28/122	Retros p
		15	52	61	24	84
		20	69	42	22	85
		25	86	27	21	90
		30	95	15	21	93

Authors	Age Mean (SD)	PSAD Cut-off^# (ng/ml/cm³)	Sensitivity	Specificity	PPV (%)	NPV (%)	Prevalence(%)	Country	PCa Event/Sample size	Design
Ude et al	66.4 (15.3)	0.15	33.3	85.7	38.2	82.8	38.2	Nigeria	97/254	Prosp.
2016 [13]		0.04	86.7	20.0	22.4	84.9

Surrogates: %free PSA and PSA density in sub-Saharan Africa
PSA- Prostate specific antigen; %fPSA- % free PSA; PSAD- prostate specific antigen density; PCa- prostate cancer; SD- standard deviation; PPV- positive predictive value; NPV- negative predictive value; nr – not reported; #-for PSA 4-10 ng/ml (grey zone); Prosp – Prospective study; Retrosp – Retrospective study