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Prostate-specific antigen testing rates and referral patterns from general practice data in England.

S Moss¹, J Melia², J Sutton¹

¹Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.

International Journal of Clinical Practice

|March 19, 2016

Summary

Prostate-specific antigen (PSA) testing rates in England are increasing, with many general practitioners (GPs) retesting men with elevated PSA levels instead of immediate referral. Routine data on PSA testing and outcomes are needed.

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Area of Science:

Urology
Public Health
General Practice

Background:

England lacks a national prostate cancer screening program.
Men can request prostate-specific antigen (PSA) tests from their general practitioner (GP).
Limited data exist on the extent of PSA testing and referral patterns.

Purpose of the Study:

To investigate the rate of PSA testing in general practice.
To analyze subsequent referral patterns following PSA testing.

Main Methods:

Utilized data from the Clinical Practice Research Datalink (CPRD) for men aged 45-84 years (2010-2011).
Linked general practice data with Hospital Episode Statistics (HES) for England.
Calculated PSA testing rates, retesting proportions, and secondary care referral rates.

Main Results:

PSA testing rates were 8.74/100 person-years in 2010 and 9.45/100 person-years in 2011.
Testing rates increased with age and decreased with deprivation.
22.4% of men with raised PSA were referred to secondary care within 14 days; 36% of the remainder were retested within 6 months.

Conclusions:

PSA testing rates have risen compared to previous studies.
Evidence suggests GPs often retest men with raised PSA instead of immediate referral.
There is a need for more routine data on PSA testing, its indications, and patient outcomes.