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PSA testing in primary care: is it time to change our practice?
Frederique Beatrice Denijs1, Hendrik Van Poppel2,3, Arnulf Stenzl4,5
1Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands.
BMC Primary Care
|December 26, 2024
Summary
Opportunistic prostate-specific antigen (PSA) testing for prostate cancer shows varied patterns among primary care physicians. A structured, risk-adapted approach is needed to improve early detection while minimizing overdiagnosis and overtreatment.
Area of Science:
- Urology
- Primary Care Medicine
- Public Health
Background:
- Historical prostate-specific antigen (PSA) screening reduced prostate cancer deaths but caused overdiagnosis/overtreatment.
- Current opportunistic PSA testing trends show rising late-stage diagnoses and prostate cancer deaths.
Purpose of the Study:
- Review current PSA testing trends in primary care.
- Propose a collaborative strategy for enhanced early prostate cancer detection.
Main Methods:
- Review of current trends in PSA testing.
- Analysis of General Practitioners (GPs) and Family Doctors (FDs) testing patterns.
- Proposal for a risk-adapted screening strategy.
Main Results:
- PSA testing patterns vary significantly among GPs/FDs due to differing guidelines, patient factors, and physician preferences.
- An organized, risk-adapted strategy can improve early diagnosis of significant prostate cancer.
- National screening programs and improved GP/FD support are recommended.
Conclusions:
- GPs/FDs are crucial in counselling men on PSA testing eligibility.
- Clearer guidance, training, and support are essential for GPs/FDs in this role.
- Risk-adapted strategies and patient information can mitigate overdiagnosis and psychosocial consequences.
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