Ten studies, involving 2,256 participants in total, were included in the review. Four of the studies had a cross-sectional design and six were case-control studies.
All of the included studies used blinded assessment.
For tPSA >4.0 ng/mL, the pooled sensitivity was 0.90 (95% CI: 0.87, 0.93) and the pooled specificity 0.58 (95% CI: 0.55, 0.60). The AUC was 80% and the DOR was 8.44 (95% CI: 4.45, 16.00).
For tPSA >10.0 ng/mL, the sensitivity was 0.65 (95% CI: 0.61, 0.70) and the specificity 0.87 (95% CI: 0.85, 0.88). The AUC was 85% and the DOR was 9.94 (95% CI: 4.15, 23.77).
For f/tPSA <0.15, the sensitivity was 0.69 (95% CI: 0.64, 0.73) and the specificity 0.82 (95% CI: 0.80, 0.83). The AUC was 87% and the DOR 13.75 (95% CI: 6.35, 29.76).
There was significant heterogeneity (p<0.001) in all estimates of specificity and DOR; it was not clear what level of heterogeneity was detected in the sensitivity estimates.