[PSA: the difficult position of general practitioners between patients and urologists].
OBJECTIVE
To determine the reasons for ordering PSA assay and delayed referral to an urologist following detection of elevated PSA in general practice.


METHODS
Retrospective study of 200 patients referred to the department by general practitioners for elevated PSA from September 2000 to April 2001.


RESULTS
The median age was 67 years (range: 52 to 87). The median PSA was 7.9 ng/ml (range: 4.1 to 897). Patients were referred after 1 to 5 PSA assays (mean: 1.6) with a median interval after discovery of elevated PSA of 1.7 months. The referral time was greater than 6 months for 52 patients (26%) and 31 patients (15.6%) were referred after more than two PSA assays were found to be elevated. PSA assay was ordered in the absence of symptoms or abnormal digital rectal examination in 43% of patients over the age of 70 years.


CONCLUSIONS
Prostate cancer screening is regularly performed in general practice. The information given to general practitioners, faced with a well informed population, appears to be insufficiently clear, as PSA assay is sometimes incorrectly ordered or interpreted.
Vincendeau
Sébastien
S
Service d'Urologie, CHU Pontchaillou, rue Henri Le Guilloux, 35033 Rennes, France. vindendeausebas@yahoo.fr
Abi Moussa
Maroun
M
Manunta
Andréa
A
Patard
Jean-Jacques
JJ
Guillé
François
F
Lobel
Bernard
B
D000368:Aged; D000369:Aged, 80 and over; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D014572:Urology
D017430:Prostate-Specific Antigen