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Major inter-laboratory variations in PSA testing practices: results from national surveys in Ireland in 2006 and 2007
F J Drummond1, L Sharp, H Comber
1National Cancer Registry Ireland, Building 6800, Airport Business Park, Kinsale Rd., Cork, Ireland. f.drummond@ncri.ie
Background:
Ireland had the highest prostate cancer incidence in Europe in 2006. In that year, the National Cancer Forum (NCF) recommended against prostate specific antigen (PSA) testing for population-based screening.
Aims:
To investigate (1) PSA services and (2) impact of the NCF recommendation.
Methods:
Questionnaires were dispatched to biochemistry laboratories nationwide in 2006 and 2007.
Results:
All 55 laboratories responded in 2006; 33/36 (89%) responded in 2007. 36 laboratories measured total PSA (tPSA); 14 measured free PSA (fPSA). Laboratories with higher tPSA workload were more likely to measure fPSA (P = 0.024). A total of 15 laboratories used age-specific PSA ranges. In 2006, there were [382,000 tPSA and [48,000 fPSA tests costing an estimated euro 4,900,000. During 2006-2007 tPSA tests increased by 11%; fPSA tests decreased by 36%.
Conclusions:
There is considerable inter-laboratory variation in PSA testing practices. Because of the potential clinical consequences, standardisation should be considered. Testing practice was unaffected by the NCF recommendation.
