PSA testing patterns in a large Swedish cohort before the implementation of organized PSA testing

Area of Science:

• Urology
• Public Health
• Cancer Screening

Background:

• Sweden is implementing organized prostate-specific antigen (PSA) testing for men aged 50-74.
• This initiative aims to reduce opportunistic testing in individuals unlikely to benefit.
• Understanding current opportunistic testing patterns is crucial for this transition.

Purpose of the Study:

• To describe opportunistic PSA testing patterns in a Swedish region prior to organized screening implementation.
• To analyze PSA testing frequency and outcomes in a defined population.

Main Methods:

• A cohort (UPSAC) was created from men PSA tested in the Uppsala-Örebro region (2012-2014).
• Data on prior testing, diagnoses, and demographics were sourced from population registries.
• Men were categorized into single and repeat PSA testers.

Main Results:

• 18.1% of the adult male population underwent PSA testing; 21% of men over 85 were tested.
• 62.1% of tested men were repeat testers, with 53.8% of those having low PSA levels (≤1µg/l).
• Prostate cancer detection rates were 2.7% for repeat testers and 4.8% for single testers.

Conclusions:

• PSA testing was prevalent, with repeat testing common even at low PSA levels.
• Frequent repeat testing, especially in older men, suggests a need for targeted interventions.
• Current patterns highlight the importance of shifting towards organized, evidence-based PSA screening.