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The patient perspective on a first raised PSA test.

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Patient experiences after a raised prostate-specific antigen (PSA) test are variable. Standardizing the care pathway for men undergoing prostate cancer investigation could improve patient understanding and GP management.

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Area of Science:

  • Urology
  • General Practice
  • Patient Experience

Background:

  • Prostate-specific antigen (PSA) testing is common in New Zealand, with approximately 350,000 tests annually.
  • While studies exist on PSA testing by general practitioners (GPs), few address the patient perspective following an elevated result.

Purpose of the Study:

  • To explore patient experiences related to prostate-specific antigen (PSA) testing, from initiation through to outcomes following a raised result.
  • Investigate the patient journey after a first elevated PSA test.

Main Methods:

  • A questionnaire-based study involving 31 general practices in New Zealand's Midland region.
  • Identification of men with a first raised PSA test in 2010 using community laboratory databases.
  • Analysis of 194 eligible responses regarding test initiation, symptoms, examinations, and referrals.

Main Results:

  • Most PSA tests (66%) were initiated by general practitioners (GPs).
  • Nearly half of men (43%) had symptoms at the time of their first raised PSA test.
  • Referral rates to specialists varied, with Maori men being less likely to be referred; 58% of men were referred, and 61% of those referred received a biopsy.

Conclusions:

  • General practitioners (GPs) predominantly initiate prostate-specific antigen (PSA) testing.
  • The care pathway following an elevated PSA result is inconsistent.
  • Standardizing the diagnostic and post-diagnostic pathway is recommended to enhance patient expectations and aid GP management in prostate cancer investigations.