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

Prostate-specific antigen (PSA) testing is not recommended as a population screening measure for prostate cancer. PSA testing is nevertheless widespread and is associated with harm due to false-positive test results, overdiagnosis and economic costs.

This study sought to document the exposure of patients to PSA testing over a decade in a general medical practice setting.

Laboratory results for each year were extracted from the clinical record. A chart review was undertaken for cases of prostate cancer.

We report 13,743 PSA results in 3313 men. In any year, 18% of all men and 33% of men aged over 50 years had at least one PSA test. Between 4.8 and 21% of first tests exceeded age normal values depending on age. There were 113 incident cancers in the study interval of which 84 (74%) were screen detected. Mortality was lower in screen-detected than symptomatic cancers.

Men at our practice are significantly exposed to PSA testing. We found evidence of possible overdiagnosis.