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Brief Report: Free Prostate-Specific Antigen Test Utilization
Consistency with Guidelines
Article first published online: 14 JUL 2005
DOI: 10.1111/j.1525-1497.2005.0181.x
Additional Information
How to Cite
Jackson, B. R. and Roberts, W. L. (2005), Brief Report: Free Prostate-Specific Antigen Test Utilization. Journal of General Internal Medicine, 20: 859–861. doi: 10.1111/j.1525-1497.2005.0181.x
Publication History
- Issue published online: 19 AUG 2005
- Article first published online: 14 JUL 2005
- Received for publication April 4, 2005 and in revised form April 8, 2005 Accepted for publication April 8, 2005
- Abstract
- Article
- References
- Cited By
Keywords:
- utilization;
- mens';
- health;
- cancer screening;
- guidelines
Background: The American Cancer Society and American Urologic Association recommend prostate cancer screening for average-risk men between the ages of 50 and 75 years using digital rectal examination and prostate-specific antigen (PSA) testing. Measuring the percent free PSA may improve test specificity for detecting prostate cancer when the total PSA is between 2.5 and 10 ng/mL.
Objective: To assess whether free PSA testing practices are consistent with published screening guidelines.
Design: Retrospective analysis of free PSA testing performed by a national reference laboratory between October 1, 2003 and September 30, 2004.
Measurements: Free PSA and total PSA results and the age of the patient at testing.
Results: Over 24% of free PSA tests were performed on patients greater than 75 years of age, and 38% were performed on patients with a total PSA either less than 2.5 ng/mL or greater than 10.0 ng/mL.
Conclusions: A substantial proportion of free PSA tests performed in a national reference laboratory appeared to be inconsistent with existing screening guidelines. This raises concern that some of these patients may have received inappropriate diagnostic workup and/or therapy, resulting in excess medical costs and potential harms.