Do general practitioners use prostate-specific antigen as a screening test for early prostate cancer?

Abstract

To assess the proportion of prostate-specific antigen (PSA) tests being ordered for prostate cancer screening. General practitioners (GPs) in central Sydney, New South Wales, ordering PSA tests during a seven-week period. Self-administered questionnaire, attached to 179 consecutive PSA test results returned to the ordering GPs. The questionnaire assessed reasons for ordering the test, associated patient morbidity and physical findings, and intended management. 66% response rate with no evidence of response bias. Of 118 PSA tests, 67 (57%) were defined as screening tests on men aged 39-84 years, not otherwise indicated for clinical reasons consistent with NHMRC guidelines. "Patient request" was the sole reason for nine (13%) of the screening tests and a factor in seven others (10%). "Routine test for age" was the reason for 25 (37%) of the screening tests, on men aged 49-78 years. Results of 59 (88%) of the screening tests were normal. More than half of the PSA tests ordered during the study period were screening tests. Our method could be used to monitor the impact of guidelines and strategies for reducing PSA screening.