Evaluation of prostate-specific antigen testing: An empirical survey of laboratories in Nigerian tertiary care centers

Background: Prostate-specific antigen (PSA) testing has been recommended for prostate cancer screening by the World Health Organization. The combined use of total and free PSA and digital rectal examination is said to improve the sensitivity and specificity of total PSA and also to reduce the need for 20% of unnecessary biopsies. Tertiary hospital laboratories ought to be appropriately equipped to offer these tests for improved patient outcomes. Objective: The objective was to determine the proportion of Nigerian tertiary care laboratories that offer quantitative total and free PSA testing. Materials and Methods: A cross-sectional survey was carried out in functional government-owned tertiary hospitals in all the geopolitical zones of Nigeria. Respondents were drawn from the Laboratory section of each hospital. Data were collected using semi-structured self-administered questionnaires and analyzed using SPSS version 22. Results: The study included a total of 34 tertiary care laboratories. The mean (SD) age of respondents was 43.71 (5.2) years. Of the surveyed hospitals, 27 (79.41%) had facilities for PSA testing, whereas 7 (20.59%) had no functional PSA testing facility. Of those with a functional testing facility, 27 (100%) had facilities for total PSA whereas 12 (44.44%) had facilities for free PSA. Three facilities [3 (42.85%)] out of the seven facilities with no functional testing facilities cited equipment breakdown as the reason. Conclusion: Availability of PSA testing facilities was not adequate in tertiary care laboratories in Nigeria, with free PSA facilities being less than total PSA facilities. More support is needed in making these important testing facilities more readily available in Nigerian tertiary healthcare laboratories.