Use of Prostate-Specific Antigen in Healthcare – Best Nursing Assignment Solutions(2022)

This article discusses the Use of Prostate-Specific Antigen in Healthcare.

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A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
What is its purpose?
How is it conducted?
What information does it gather?
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

…

Solution

Prostate-Specific Antigen

Use of Prostate-Specific Antigen in Healthcare

Other than being the second most common cancer globally, prostate cancer is the sixth leading cause of cancer deaths (Sadeghi-Gandomani et al., 2017). According to Sadeghi-Gandomani, about 1.1 million prostate cancer cases occurred, and 307000 deaths were recorded in 2012. About 42% of prostate cancer cases occur in men above 50 years, with many of them being diagnosed after the age of 60.

Even though research shows that the incidence of prostate cancer and mortality rates are among the uppermost for Black Americans, the data does not give clear results about the rates of prostate cancer in American men (Taitt, 2018). Data indicates that prostate-specific antigen testing and incidence of the disease have significantly escalated in developing countries. In those countries, prostate cancer has turned to be leading cancer in men.

This essay, therefore, purposes to explore how the healthcare system uses PSA. An evaluation of the test’s reliability and validity is also given and a description of any issues with reliability, predictive values, and sensitivity.

Description of PSA

Prostate-specific antigen (PSA) defines a glycoprotein that is only produced by the prostate. Its work is to liquefy semen. Its small amounts drip into the bloodstream where its measurements can be taken. Prostate-specific antigen is not cancer-specific, but it is tissue specific. High levels can occur in men having prostatitis, benign prostatic hypertrophy, prostatic infarction, or urinary tract infection.

Purpose of PSA

Early detection of prostate cancer can help in getting timely and appropriate treatment. Although men who have prostate cancer may have high PSA levels, many non-cancerous conditions can also lead to an elevated PSA level. The PSA test can discover high PSA levels in the blood. However, it does not provide accurate diagnostic information concerning the prostate condition.

Other tests, such as the digital rectal exam (DRE), may be used and the PSA test to screen for any primary signs of prostate cancer. Therefore, general practitioners get valuable information in their medical practice to monitor treated and untreated prostate cancer. PSA also enhances the monitoring and management of post-treatment of men with prostate cancer. It is, therefore, possible to detect disease reoccurrence.

Additionally, high brisk tumors can be identified through PSA testing. Furthermore, the PSA test may be useful in judging the effectiveness of treatment.

Conducting a PSA Test

During the PSA test, the doctor inserts a gloved finger lubricated in the rectum to reach the prostate. The doctor judges whether there are any problem areas or abnormal lumps by pressing on or feeling the prostate. Nevertheless, PSA and DRE do not provide sufficient information for the diagnosis of prostate cancer. The abnormality of these results may make the doctor endorse a prostate biopsy. In the process, tissue samples are removed for an examination in the laboratory; The basement of a cancer diagnosis is based on biopsy results.

Information Gathered During PSA Test

Prostate cancer risk in males varies with the PSA levels. PSA test results are reported in PSA nanograms per millimeter of blood. (Ng/mL). However, no specific cutoff point exists between an abnormal and normal level of PSA. PSA level may change over time-PSA velocity. Rapid elevation of the PSA may show an aggressive cancer form or that cancer is present.

Additionally, a high PSA level but having a lot of free PSA percentage may also indicate prostate cancer. Moreover, there may be more PSA production per tissue volume than conditions of benign prostate can do. Measures of PSA density alters the values of PSA for prostate volume. The PSA test may also indicate the growth rate of cancer. Cancer may be either fast or slow-growing.

While slow-growing cancer may not impact the longevity of a patient’s life, fast-growing cancer requires to be treated. The cause of raised PSA levels needs to be determined as the elevation may indicate other non-cancerous conditions such as urine infection and prostatitis.

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Evaluation of PSA and issues to do with Validity, Reliability, and predictive values

           PSA serum concentrations have been extensively used to detect prostate cancer and oncology and have also been designated the best circulating tumor marker. European Randomized Study of Screening for Prostate Cancer (ERSPC) reported a decrease of 20% in prostate cancer death rate in the screening exercise with the occurrence of considerable overdiagnosis and overtreatment. ERSPC indicates that though extensive overdiagnosis and overtreatment, screening and early intervention can lower prostate cancer mortality rate.

Though PSA validly predicts subsequent prostate cancer, Huang et al. (2018) acknowledge that no PSA cutoff value reaches the likelihood that is formally needed for a screening test. Even though PSA concentrations below 1.0 ng/ml virtually rule out a prostate cancer diagnosis and; increased PSA concentrations, it expresses a range of prostate cancer risk.

As compared to other accepted biomarkers, PSA confers very high odds ratios even for concentrations that are moderately raised. According to the Alzheimer’s Association. (2018), tumor characteristics impact the sensitivity estimates. However, sensitivity can only be calculated when the case status for all participants in the study is known. Huang et al., 2018 acknowledge that the free/total (f/t) PSA ratio offers high diagnostic sensitivity and specificity. Inadequate PSA-kinetics reliability with the inclusion of PSA doubling time in active surveillance (AS) makes repeated biopsy to be indispensable for each AS program.

            Earlier studies indicate that about10% of men in the middle age have PSA concentrations that above4ng/ml and the estimated number of these men who have prostate cancer biopsy is a quarter. With men having high PSA concentrations, positive PSA values for prostate cancer diagnosis can be provided in a study since they have a biopsy for the diagnosis verification.

 To conclude, men at high risk of developing prostate cancer in the future can be identified when early PSA tests are conducted, and they can therefore be directed to SA. Though PSA helps in early detection of prostate cancer, it leads to overdiagnosis, overtreatment, and unnecessary prostate cancer biopsies. While F/t PSA ratio results should always be joined with other established diagnostic methods, a close examination should be done to determine the cause of elevated PSA levels.

References

Alzheimer’s Association. (2018). 2018 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 14(3), 367-429.

Huang, Y., Li, Z. Z., Huang, Y. L., Song, H. J., & Wang, Y. J. (2018). Value of free/total prostate-specific antigen (f/t PSA) ratios for prostate cancer detection in patients with total serum prostate-specific antigen between 4 and 10 ng/mL: A meta-analysis. Medicine, 97(13).

Sadeghi-Gandomani, H., Yousefi, M., Rahimi, S., Yousefi, S., Karimi-Rozveh, A., Hosseini, S., … & Salehiniya, H. (2017). The incidence, risk factors, and knowledge about the prostate cancer through worldwide and Iran. World Cancer Research Journal, 4(4), 1-8.

Taitt, H. E. (2018). Global trends and prostate cancer: a review of incidence, detection, and mortality as influenced by race, ethnicity, and geographic location. American journal of men’s health, 12(6), 1807-1823.

Question

Include the following:

• A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
  • What is its purpose?
  • How is it conducted?
  • What information does it gather?
• Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

Related FAQs

1. What is prostate-specific antigen (PSA)?

Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. For this test, a blood sample is sent to a laboratory for analysis.

2. Can detecting prostate cancer early reduce the risk of death?

Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a man’s chance of dying from prostate cancer.

3. Do age-specific PSA reference ranges improve the accuracy of prostate cancer tests?

Because a man’s PSA level tends to increase with age, it has been suggested that the use of age-specific PSA reference ranges may increase the accuracy of PSA tests. However, age-specific reference ranges have not been generally favored because their use may delay the detection of prostate cancer in many men.

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4. When was the PSA test for prostate cancer approved?

In 1994, FDA approved the PSA test to be used in conjunction with a digital rectal exam (DRE) to aid in the detection of prostate cancer in men 50 years and older. Until about 2008, many doctors and professional organizations had encouraged yearly PSA screening for prostate cancer beginning at age 50.

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