Rates of prostate-specific antigen testing in general practice in England and Wales in asymptomatic and symptomatic patients: a cross-sectional study
Article first published online: 24 JUN 2004
Volume 94, Issue 1, pages 51–56, July 2004
How to Cite
Melia, J., Moss, S., Johns, L. and contributors in the participating laboratories (2004), Rates of prostate-specific antigen testing in general practice in England and Wales in asymptomatic and symptomatic patients: a cross-sectional study. BJU International, 94: 51–56. doi: 10.1111/j.1464-4096.2004.04832.x
- Issue published online: 24 JUN 2004
- Article first published online: 24 JUN 2004
- Accepted for publication 10 March 2004
- prostate specific antigen;
- mass screening;
- prostatic neoplasms;
- primary health care;
To assess the rate of prostate-specific antigen (PSA) testing for prostate cancer in general practice in asymptomatic and symptomatic patients.
SUBJECTS AND METHODS
The cross-sectional study took place in England and Wales, was population-based and covered 469 159 men aged 45–84 years. Pathology data on PSA tests requested between 19 November 1999 and 31 May 2002 by general practitioners (GPs) were provided by 28 pathology laboratories. The practices recorded reasons for the tests between 1 December 2001 and 31 May 2002. In all, 391 practices in which all GP partners participated were included in the analyses.
The overall annual rate of testing in men with no previous diagnosis of prostate cancer was estimated to be 6%, of which the annual rates of asymptomatic, symptomatic and re-testing were 2.0%, 2.8% and 1.2%, respectively, after adjusting for missing values. The rate decreased with increasing social deprivation, and with increasing proportions of black and Asian populations. The overall rate of PSA testing increased significantly from 1999 to 2002.
If the recommendations of the National Health Service Prostate Cancer Risk Management Programme were applied, 14% of asymptomatic tests and 23% of symptomatic tests would have led to a referral. As the rate of PSA testing is increasing and there are uncertainties about the benefit of screening, the workload and costs in general practice and hospitals should be monitored.