How much testing for prostate cancer is taking place in England and Wales?
There are no routinely collected data in the UK with which to monitor or study the extent to which men are being tested for prostate cancer. These data are important if we wish to know the amount of testing that is taking place, its impact on the workload of the NHS and future changes in incidence of and mortality from prostate cancer.
The Policy Research Programme of the Department of Health funded an independent investigation of the rate of Prostate Specific Antigen (PSA) measurement in general practice in England and Wales. The study was conducted by the Cancer Screening Evaluation Unit at The Institute of Cancer Research in association with 28 pathology laboratories and over 300 general practices. The aim of the study was to investigate the rate of PSA testing in asymptomatic men and to study factors associated with variation in the rate of testing within general practice. The overall annual rate of testing in men with no prior diagnosis of prostate cancer was estimated to be 6.0 per 100 men, of which the annual rates of asymptomatic testing, symptomatic testing and re-testing were 2.0, 2.8 and 1.2 per 100 men respectively after adjusting for missing values. The rate decreased with increasing social deprivation, and increasing proportions of black and Asian populations. The overall rate of PSA testing increased significantly from 1999 to 2002. If the recommendations of the NHS Prostate Cancer Risk Management Programme were applied, 14 per cent of asymptomatic tests and 23 per cent of symptomatic tests would have led to referral. As the rate of PSA testing is rising and there are uncertainties about the benefit of screening, the workload and costs in general practice and hospitals should be monitored.
A peer review paper has been published in the British Journal of Urology International1.