Screening for prostate cancer in New Zealand general practice

To ascertain the rates and patterns of prostate-specific antigen (PSA) screening in New Zealand men.

The study population included 35,958 men aged 40+ years, with no prior diagnosis of prostate cancer, enrolled in 31 general practices in the Midland Cancer Network Region of New Zealand in 2010. Computerized practice records were searched for information, including reasons for testing, for men with elevated PSA test results in 2010. PSA results for 2007-2010 were obtained from community laboratories. Screened men were identified and screening rates calculated by age.

Of 9344 men who underwent one or more PSA tests in 2010, 84.9% were classified as having been screened. The overall screening rate was 22.1%, with 24.4% of men aged 70+ years screened. Elevated PSA levels were found in 2.1% of screened men. Of the men screened in 2010, 57.3% had had a screening test in the previous three years.

General practitioners in New Zealand commonly screen men (including those aged 70+) for prostate cancer, despite the lack of trial evidence that these men would benefit from screening. The value of annual PSA testing in men with previous normal PSA levels is unproven. Longer intervals between tests would be appropriate.