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Do general practitioners use prostate-specific antigen as a screening test for early prostate cancer?
J E Ward1, L Gupta, N J Taylor
1Central Sydney Area Health Service Needs Assessment and Health Outcomes Unit, NSW. jward@nah.rpa.cs.nsw.gov.au
The Medical Journal of Australia
|August 8, 1998
Summary
More than half of prostate-specific antigen (PSA) tests ordered by GPs were for screening, not clinical indications. This study highlights the need for monitoring PSA screening practices to align with guidelines.
Area of Science:
- Urology
- Oncology
- General Practice
Background:
- Prostate-specific antigen (PSA) testing is a key tool for prostate cancer detection.
- Guidelines exist to standardize PSA test ordering for prostate cancer screening.
- Understanding current PSA testing practices is crucial for effective guideline implementation.
Purpose of the Study:
- To determine the proportion of PSA tests ordered for prostate cancer screening by general practitioners.
- To identify reasons for PSA test ordering in a primary care setting.
Main Methods:
- A questionnaire-based study involving general practitioners (GPs) in Sydney, Australia.
- 179 consecutive PSA test results were linked to a self-administered questionnaire.
- The questionnaire collected data on the reasons for ordering, patient factors, and intended management.
Main Results:
- A 66% response rate was achieved with no evidence of response bias.
- 57% of 118 PSA tests were classified as screening tests in men aged 39-84 years.
- Patient request and routine age-based testing were significant drivers for screening.
Conclusions:
- Over half of the PSA tests analyzed were for screening purposes, often without clear clinical indications.
- The study provides a methodology for monitoring the impact of interventions aimed at reducing PSA screening.
- Findings underscore the importance of adherence to clinical guidelines for PSA testing.