Using multiple cutpoints for the free-to-total prostate specific antigen ratio improves the accuracy of prostate cancer detection.

Background: Using a single cutpoint for the free-to-total (F/T) prostate specific antigen (PSA) ratio loses important diagnostic information. We evaluated the performance of multiple F/T PSA cutpoints in detecting prostate cancer in men with nonspecific PSA values.

Methods: We extracted sensitivity and specificity data from 12 studies reporting on >or=30 cancer patients with PSA values between 2.