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Prostate Specific Antigen (PSA) Testing in a General Practice 2009-2019

Overview
Journal Ir J Med Sci
Specialty General Medicine
Date 2024 Oct 23
PMID 39441509
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Abstract

Background: Prostate-specific antigen (PSA) testing is not recommended as a population screening measure for prostate cancer. PSA testing is nevertheless widespread and is associated with harm due to false-positive test results, overdiagnosis and economic costs.

Aims: This study sought to document the exposure of patients to PSA testing over a decade in a general medical practice setting.

Methods: Laboratory results for each year were extracted from the clinical record. A chart review was undertaken for cases of prostate cancer.

Results: We report 13,743 PSA results in 3313 men. In any year, 18% of all men and 33% of men aged over 50 years had at least one PSA test. Between 4.8 and 21% of first tests exceeded age normal values depending on age. There were 113 incident cancers in the study interval of which 84 (74%) were screen detected. Mortality was lower in screen-detected than symptomatic cancers.

Conclusions: Men at our practice are significantly exposed to PSA testing. We found evidence of possible overdiagnosis.

References
1.
Schroder F, Hugosson J, Roobol M, Tammela T, Zappa M, Nelen V . Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014; 384(9959):2027-35. PMC: 4427906. DOI: 10.1016/S0140-6736(14)60525-0. View

2.
Pinsky P, Prorok P, Yu K, Kramer B, Black A, Gohagan J . Extended mortality results for prostate cancer screening in the PLCO trial with median follow-up of 15 years. Cancer. 2016; 123(4):592-599. PMC: 5725951. DOI: 10.1002/cncr.30474. View

3.
Martin R, Donovan J, Turner E, Metcalfe C, Young G, Walsh E . Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial. JAMA. 2018; 319(9):883-895. PMC: 5885905. DOI: 10.1001/jama.2018.0154. View

4.
Vickers A, OBrien F, Montorsi F, Galvin D, Bratt O, Carlsson S . Current policies on early detection of prostate cancer create overdiagnosis and inequity with minimal benefit. BMJ. 2023; 381:e071082. DOI: 10.1136/bmj-2022-071082. View

5.
Hoffmann T, Del Mar C . Patients' expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Intern Med. 2014; 175(2):274-86. DOI: 10.1001/jamainternmed.2014.6016. View