Application of Bootstrap Resampling Technique to Obtain Confidence Interval for Prostate Specific Antigen (PSA) Screening Age

Abstract

Prostate-specific antigen (PSA) testing is one of the most commonly used screening tools to detect clinically significant prostate cancers at a stage when intervention reduces morbidity and mortality. However age-specific reference ranges have not been generally favored because their use may delay the detection of prostate cancer in many men and as such may lead to harm in terms of overdiagnosis and overtreatment. The widespread use of PSA has proven controversial as the evidence for benefit as a screening test in asymptomatic men is still subject to debate. In this article, we applied bootstrap resampling technique to obtain the confidence interval for PSA screening age among prostate cancer patients in Nigeria. The bootstrap analysis is a useful technique for investigating variations among selected models in samples drawn at random with replacement, its distribution is used to estimate more robust empirical confidence intervals and is useful when the usual modeling methods based on assumptions about sampling distributions are untrustworthy or unavailable. The study is particularly relevant in light of the recent controversy about prostate cancer screening.