Clinical Edge

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PCa3 Helps Guide Prostate Biopsy Need

Key clinical point: Urinary prostate cancer antigen 3 has an acceptable diagnostic accuracy and can be used as a guide for the first biopsy.

Major finding: Based on the meta-analysis, sensitivity was 0.69, specificity was 0.65, diagnostic odds ratio were 4.244, and the area under the curve was 0.734 with a heterogeneity of 0%. “PCA3 reveals better results, suggesting a greater usefulness for PCA3 in directing patients to prostate biopsy. Due to the better specificity, only those patients who really need this procedure would be referred, thereby reducing biopsies in patients without cancer,” noted the investigators.

Study details Nine studies met inclusion criteria using database searches, with an average of 336 patients per study.

Disclosures: None reported.


Rodríguez SVM. Can Urol Assoc J. 2019 Nov 29. doi: 10.5489/cuaj.6008.


A diagnosis of prostate cancer presents ongoing challenges. Prostate cancer is a heterogeneous disease, and the optimal timing of biopsy, while avoiding unnecessary biopsy, is an important goal. Prostate cancer antigen (PSA) testing, while utilized widely, is suboptimal. Thus, significant effort has been expended to identify improved biomarkers and selection criteria to improve diagnosis, while minimizing harm and anxiety in patients. Rodriguez et al. conducted a systematic review and meta-analysis regarding the diagnostic accuracy of PCA3. They found that PCA3 was associated with a sensitivity of 69% and a specificity of 65%. These findings are a valuable next step towards the goal of improved diagnostic accuracy and performance in prostate cancer.—Mark A. Klein, MD