IngentaConnect Brief Report: Free Prostate-Specific Antigen Test Utilization: Co...

Authors: Jackson, Brian R.; Roberts, William L.

Source: Journal of General Internal Medicine, Volume 20, Number 9, September 2005 , pp. 859-861(3)

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Abstract:

Background:

The American Cancer Society and American Urologic Association recommend prostate cancer screening for average-risk men between the ages of 50 and 75 years using digital rectal examination and prostate-specific antigen (PSA) testing. Measuring the percent free PSA may improve test specificity for detecting prostate cancer when the total PSA is between 2.5 and 10 ng/mL. Objective:

To assess whether free PSA testing practices are consistent with published screening guidelines. Design:

Retrospective analysis of free PSA testing performed by a national reference laboratory between October 1, 2003 and September 30, 2004. Measurements:

Free PSA and total PSA results and the age of the patient at testing. Results:

Over 24% of free PSA tests were performed on patients greater than 75 years of age, and 38% were performed on patients with a total PSA either less than 2.5 ng/mL or greater than 10.0 ng/mL. Conclusions:

A substantial proportion of free PSA tests performed in a national reference laboratory appeared to be inconsistent with existing screening guidelines. This raises concern that some of these patients may have received inappropriate diagnostic workup and/or therapy, resulting in excess medical costs and potential harms.

Brief Report: Free Prostate-Specific Antigen Test Utilization: Consistency with Guidelines