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December 9, 1992

Cancer of the Prostate

Author Affiliations

Amesbury, Mass

JAMA. 1992;268(22):3197. doi:10.1001/jama.1992.03490220040014

To the Editor.  —As a nonresearcher clinician, I get confused enough already by statistical terms such as specificity, sensitivity, false-positive, and true-negative. I don't need to be made more confused by those who write the editorials, such as Oesterling in his JAMA Editorial on PSA testing.1The study by Carter et al2 in the same issue demonstrated an improved specificity, but unimproved or worsened sensitivity of the PSA test for detecting prostate cancer, by using its rate of change per year rather than its absolute value.Oesterling, in referring to that study, states, "The sensitivity for the rate of change (of PSA) was not significantly better than that for serum PSA concentration." He then contradicts himself with the statement, "Thus, the serum PSA level going from 1.8 μg/L to 2.9 μg/L in 1 year's time would be significant and may lead to the detection of potentially curable prostate