Assessment Tools and Diagnostic Tests in Adults and Children
In the present discussion, the Prostrate-specific antigen test will form the basis of the examination. According to statistics, prostate cancer afflicts more people from the age of 65 and above in the United States (Adhyam & Gupta, 2012). Genetics play a role in the prevalence of the disease as more African-Americans have been found with the condition compared to their counterparts whereas family history also predisposes men to it. Given that prostate cancer can occur slowly or rapidly, screening plays an important role in its management. The purpose of this paper therefore is to examine the prostrate-specific antigen test as well as assess children from the provided list.
Description of the Tool
Prostate cancer is primarily screened through a blood-test referred to as the prostate-specific antigen-test (PSA). PSA is thus the biomarker for prostate cancer and is actually a protein produ
ced by both malignant and non-malignant tissues in the affected region. The PSA test works through drawing of blood from a patient’s artery or vein, which will be sent to the laboratory for examination (Adhyam & Gupta, 2012). If the level of the PSA in the blood sample is more than 4 mg/ml, then cancer could be diagnosed. However, the utilization of this PSA level is still shrouded in controversy since such results may also indicate the presence of other diseases such as inflamed or enlarged prostate. Thus, in order to truly conclude the presence of prostate cancer, additional tests such as biopsy, ultrasound, prostate exams and even the recent multiparametric-prostate-magnetic resonance imagining (MP-MRI) become necessary (Stamatakis & Pinto, 2014).
PSA Test’s Validity, Reliability, Sensitivities, and Predictive Values
The validity of the PSA Test for screening cancer patients has always been a subject of discussion. Whereas the
test is valid when it comes to cancer screening, particularly in early stages, its overall validity does not inspire confidence since its effect on mortality has not been determined (Leal, Welton, & Martin, 2018). Further, the PSA test’s reliability has also been called into question. Whereas the tool can detect abnormal levels of PSA in the blood, it does not offer an accurate diagnostic information concerning the state of one’s prostate. Thus, one needs to adopt the usage of other tests in order to achieve this objective. Further, it is not useful in screening early stages of this cancer as mentioned above without proving useful for late stage prostate cancer.
Moreover, the usage of PSA test has also been characterized by diametrically different opinions from doctors and studies. For instance, while the tool has provided early detection of prostate cancer, its usefulness as regards saving lives has no clear cut answer. Also, the existence of the PSA levels of more than 4mg/ml has generated a controversy in the scientific circles as it does not necessarily appear as a biomarker for prostate cancer (Laine, 2012). Recommendations have also been made to use the upper range of values of normal when it comes to PSA for older adults. However, this only serves to reduce the sensitivity of the PSA tool for older adults’ prostate screening. Therefore, whereas the PSA cut off 4 ng/mL has expressed low sensitivities in studies, its specificity has increased as incidences of false positive tests are almost negligible.
References
Adhyam, M., & Gupta, A. K. (2012). A Review on the Clinical Utility of PSA in Cancer Prostate. Indian journal of surgical oncology, 3(2), 120-9.
Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine, 156(2), 162–163. Retrieved from the Walden Library databases.
Leal, J., Welton, N., & Martin, R. (2018). Estimating the sensitivity of a prostate cancer screening programme for different PSA cut-off levels: A uk case study. Cancer Epidemiology, 52, 99-105.
Stamatakis, L., … Pinto, P. A. (2014). Diagnostic value of biparametric magnetic resonance imaging (MRI) as an adjunct to prostate-specific antigen (PSA)-based detection of prostate cancer in men without prior biopsies. BJU International, 115(3), 381-388. doi:10.1111/bju.12639