title: PSA-use in a Spanish industrial area.
abstract: OBJECTIVE
  To document the extent of prostate-specific antigen (PSA)-testing in the general population at Getafe (Spain) outside our prostate cancer (PC) screening program, and to check its performance in terms of PC detection.
  
  
  METHODS
  A total of 5371 PSA-test records (1997-1999) were reviewed and testing rates estimated per 1000 person-years. The extent of patient referral (men referred to our facilities) was calculated adjusting for PSA levels. To approach the performance of testing in the general population, our PC screening program acted as a standard for comparison. The probability of missing one PC in the general population was estimated in terms of number of men necessary to screen (NNS). Calculations were made adjusting for PSA levels.
  
  
  RESULTS
  PSA-testing rate in the general population was 21.6/1000 person-years. In the age-group 55-69 years, this rate was 86.8/1000 (152.6 in men >70 years). Referral rates were 67.9 and 39.5% for men with PSA 4-10 and >10 ng/ml, respectively. Overall PC detection rate was 1.76%. Detection rates for PSA 4-10 and >10 ng/ml were 4.66 and 12.94%, respectively. When compared with the performance of the screening program, for every 17 men with a PSA in the range 4-10 ng/ml one cancer was missed (95% confidence interval (CI), 9-580). Similarly, one cancer was lost for every four men with a PSA >10 ng/ml (95% CI, 2-8).
  
  
  CONCLUSIONS
  The extent of opportunistic testing in our setting is very high, particularly in the older age groups. Opportunistic screening renders PC detection rates lower than expected for every PSA level and cannot be encouraged.
authors.affiliation: Urology Department, Hospital Universitario de Getafe, Madrid, Spain. apaez@hugf.insalud.es
authors.forename: Alvaro
authors.initials: A
authors.lastname: Páez
authors.forename: Marcos
authors.initials: M
authors.lastname: Luján
authors.forename: Luis
authors.initials: L
authors.lastname: Llanes
authors.forename: Ignacio
authors.initials: I
authors.lastname: Romero
authors.forename: M Angel
authors.initials: MA
authors.lastname: de la Cal
authors.forename: Elena
authors.initials: E
authors.lastname: Miravalles
authors.forename: Antonio
authors.initials: A
authors.lastname: Berenguer
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis; D013030:Spain / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen