Outcomes and PSA testing in general practice

Fraser Hodgson, Zuzana Obertova, Charis Brown, Ross Lawrenson,

Waikato Clinical School, University of Auckland

Abstract:

Introduction:

In New Zealand Prostate Specific Antigen (PSA) testing has increased significantly, 275000 tests are done annually. Controversy exists around PSA testing as part of an unorganised screening program.

Aim:

To look at the use of PSA testing in a sample of general practices and investigate the reasons GPs undertook PSA testing.

Methods:

Five Waikato general practices were investigated looking at PSA laboratory tests of men 40 years and over in 2010. These were compared against GP notes. Testing rates; reasons for testing; histology and referral/s were examined for different age groups. A questionnaire was sent to the GPs to determine their views on PSA testing.

Results:

Men, 40 years and over had a 25% chance of having a PSA test. Of these, 71% were asymptomatic. Of PSA tests done on older men (70+ years), 56% were asymptomatic. Ten percent of all PSA tests were elevated. Twenty one of 23 prostate cancers were identified through PSA testing. Opportunistic testing yielded 4/23 (17%) prostate cancers, the rest (83%) had histories of prostate pathology or LUTS. The questionnaire confirmed GPs belief of PSA screening and some difficulties in educating patients.


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