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that fall into a gray zone. PSA levels of 10 ng/mLor above are abnormal and are suggestive of malignant activity of the prostate (Dain et al., 2018).Validity and ReliabilityThe validity of the PSA-test has been proven effective in detecting prostate cancer and monitoring the effects of cancer treatment of the prostate (Ahmad, et al., 2017). A PSA test may help detect prostate cancer at an early stage. However, the reliability of the test has its limitations. Although the PSA is an excellent screening tool for prostate cancer, a high-level is not 100% indicative that a man has prostate cancer. There are some limitations to the test that canincrease the value of the test that are not considered cancerous such as; prostatitis, benign prostatic hyperplasia (BPH), or the normal increase of PSA with age. Serum calcium and serum 1
parathyroid hormone (PTH) stimulates prostate growth in men without clinical prostate cancer. Conditions that can lower the results of PSA limiting reliability of the test are; certain drugs that are used to treat BPH, chemotherapy, and obesity (Mayo Clinic, 2018). An elevated PSA-test result necessarily does not indicate that a patient has prostate cancer, nor does a low level indicate that a patient does not have prostate cancer. Men can have a low PSA-test result and stillhave prostate cancer. Due to a large number of factors that can alter PSA levels, there are a significant number of men who are misdiagnosed as having prostate cancer (Okello et al., 2014).