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Disorders of the Male Reproductive System01:20

Disorders of the Male Reproductive System

342
Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
342

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Prostate Specific Antigen (PSA) testing in a general practice 2009-2019.

Niall Maguire1, Andrea Moloney2, Krzysztof Fic3

  • 1Bedford Medical Centre, Navan, Ireland. niall.maguire@icgp.ie.

Irish Journal of Medical Science
|October 23, 2024
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Summary
This summary is machine-generated.

Men frequently undergo prostate-specific antigen (PSA) testing, despite its lack of recommendation for population screening. This widespread testing may lead to overdiagnosis and associated harms in general practice settings.

Keywords:
General practiceOverdiagnosisProstate cancerProstate-specific antigen (PSA)Screening

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Area of Science:

  • Urology
  • Public Health
  • Clinical Medicine

Background:

  • Prostate-specific antigen (PSA) testing is not recommended for population-wide prostate cancer screening.
  • Despite guidelines, PSA testing remains prevalent, leading to potential harms like false positives and overdiagnosis.
  • Economic costs associated with widespread PSA testing are also a concern.

Purpose of the Study:

  • To document patient exposure to PSA testing over a ten-year period within a general medical practice.
  • To analyze the frequency and outcomes of PSA testing in a real-world clinical setting.

Main Methods:

  • Extraction of laboratory results for PSA tests from clinical records annually.
  • Conducting a chart review for all identified cases of prostate cancer.
  • Analyzing 13,743 PSA results from 3313 men over the study period.

Main Results:

  • Annually, 18% of all men and 33% of men over 50 years received at least one PSA test.
  • First-time PSA tests exceeded age-specific normal values in 4.8% to 21% of cases.
  • Of 113 incident prostate cancers, 84 (74%) were detected through screening, with lower mortality in screen-detected cases.

Conclusions:

  • Patients in this general practice setting experience significant exposure to PSA testing.
  • Evidence suggests a potential for overdiagnosis of prostate cancer due to widespread PSA testing.