PSA testing in primary care: is it time to change our practice?
Abstract Background Historical prostate-specific antigen (PSA)-based screening studies reduced prostate cancer-related deaths but also led to overdiagnosis/overtreatment. Since then, opportunistic PSA testing has increased, and late-stage diagnoses and prostate-cancer related deaths are rising. Obje...
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| Format: | Article |
| Language: | English |
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BMC
2024-12-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-024-02688-8 |
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| author | Frederique Beatrice Denijs Hendrik Van Poppel Arnulf Stenzl Tiago Villanueva Josep Maria Vilaseca Mehmet Ungan André Deschamps Sarah Collen Monique J. Roobol |
| author_facet | Frederique Beatrice Denijs Hendrik Van Poppel Arnulf Stenzl Tiago Villanueva Josep Maria Vilaseca Mehmet Ungan André Deschamps Sarah Collen Monique J. Roobol |
| author_sort | Frederique Beatrice Denijs |
| collection | DOAJ |
| description | Abstract Background Historical prostate-specific antigen (PSA)-based screening studies reduced prostate cancer-related deaths but also led to overdiagnosis/overtreatment. Since then, opportunistic PSA testing has increased, and late-stage diagnoses and prostate-cancer related deaths are rising. Objectives To review current trends regarding PSA testing in primary care and propose a collaborative approach to improve early prostate cancer detection. Discussion Opportunistic PSA testing patterns vary among General Practitioners (GPs) and Family Doctors (FDs) based on differing guidelines, patient pressure, time constraints and personal views/preferences. However, an organised, risk-adapted strategy, as outlined by the European Association of Urology’s guidelines, could facilitate the early diagnosis of significant prostate cancer whilst sparing those unlikely to experience disease-related symptoms from further tests (overdiagnosis) as well as the psychosocial consequences of a cancer diagnosis. This could be achieved by the introduction of national prostate cancer screening programmes, which has been endorsed in the European Commission’s publication of the EU Cancer Screening Recommendations. In this scenario, GPs/FDs would still play an important role in supporting men throughout the decision pathway. However, as some men may still request a PSA test from their GP/FD, patient information as well as clear guidance and support to GPs/FDs are needed, including appropriate skills training to facilitate effective counselling and informed decision-making, and the use of risk calculators to inform referral decisions. Conclusion GPs/FDs play an important role in counselling healthy men eligible to consider PSA testing. However, clear guidance, training and support is required for them to assume this role. |
| format | Article |
| id | doaj-art-84119f196dbb40f0b7a13fc36edfe4a2 |
| institution | Kabale University |
| issn | 2731-4553 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-84119f196dbb40f0b7a13fc36edfe4a22024-12-29T12:39:39ZengBMCBMC Primary Care2731-45532024-12-012511810.1186/s12875-024-02688-8PSA testing in primary care: is it time to change our practice?Frederique Beatrice Denijs0Hendrik Van Poppel1Arnulf Stenzl2Tiago Villanueva3Josep Maria Vilaseca4Mehmet Ungan5André Deschamps6Sarah Collen7Monique J. Roobol8Department of Urology, Erasmus Cancer Institute, Erasmus University Medical CentreDepartment of Urology, KU LeuvenDepartment of Urology, Eberhard Karls University TübingenReynaldo Dos Santos Family Health UnitDepartment of Primary Healthcare, Althaia Foundation, Clinical and University NetworkWorld Organization of Family Doctors (WONCA- Europe) and Department of Family Medicine, Ankara UniversityEuropa UomoEuropean Association of UrologyDepartment of Urology, Erasmus Cancer Institute, Erasmus University Medical CentreAbstract Background Historical prostate-specific antigen (PSA)-based screening studies reduced prostate cancer-related deaths but also led to overdiagnosis/overtreatment. Since then, opportunistic PSA testing has increased, and late-stage diagnoses and prostate-cancer related deaths are rising. Objectives To review current trends regarding PSA testing in primary care and propose a collaborative approach to improve early prostate cancer detection. Discussion Opportunistic PSA testing patterns vary among General Practitioners (GPs) and Family Doctors (FDs) based on differing guidelines, patient pressure, time constraints and personal views/preferences. However, an organised, risk-adapted strategy, as outlined by the European Association of Urology’s guidelines, could facilitate the early diagnosis of significant prostate cancer whilst sparing those unlikely to experience disease-related symptoms from further tests (overdiagnosis) as well as the psychosocial consequences of a cancer diagnosis. This could be achieved by the introduction of national prostate cancer screening programmes, which has been endorsed in the European Commission’s publication of the EU Cancer Screening Recommendations. In this scenario, GPs/FDs would still play an important role in supporting men throughout the decision pathway. However, as some men may still request a PSA test from their GP/FD, patient information as well as clear guidance and support to GPs/FDs are needed, including appropriate skills training to facilitate effective counselling and informed decision-making, and the use of risk calculators to inform referral decisions. Conclusion GPs/FDs play an important role in counselling healthy men eligible to consider PSA testing. However, clear guidance, training and support is required for them to assume this role.https://doi.org/10.1186/s12875-024-02688-8ScreeningPrimary careProstate cancerProstate-specific antigen |
| spellingShingle | Frederique Beatrice Denijs Hendrik Van Poppel Arnulf Stenzl Tiago Villanueva Josep Maria Vilaseca Mehmet Ungan André Deschamps Sarah Collen Monique J. Roobol PSA testing in primary care: is it time to change our practice? BMC Primary Care Screening Primary care Prostate cancer Prostate-specific antigen |
| title | PSA testing in primary care: is it time to change our practice? |
| title_full | PSA testing in primary care: is it time to change our practice? |
| title_fullStr | PSA testing in primary care: is it time to change our practice? |
| title_full_unstemmed | PSA testing in primary care: is it time to change our practice? |
| title_short | PSA testing in primary care: is it time to change our practice? |
| title_sort | psa testing in primary care is it time to change our practice |
| topic | Screening Primary care Prostate cancer Prostate-specific antigen |
| url | https://doi.org/10.1186/s12875-024-02688-8 |
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