title: PSA testing for prostate cancer: an online survey of the views and reported practice of General Practitioners in the UK.
abstract: BACKGROUND
  The role of Prostate Specific Antigen (PSA) testing in the early detection of prostate cancer is controversial. Current UK policy stipulates that any man who wishes to have a PSA test should have access to the test, provided he has been given full information about the benefits and limitations of testing. This study aimed to determine UK GPs' current reported practice regarding PSA testing, and their views towards informed decision-making and PSA testing.
  
  
  METHODS
  Online questionnaire survey, with a sample of 421 GPs randomly selected from a database of GPs across the UK.
  
  
  RESULTS
  95% (400/421) of GPs responded. 76% of GPs reported having performed a PSA test for an asymptomatic man at least once in the previous three months, with 13% reported having tested more than five men in this period. A majority of GPs reported they would do a PSA test for men presenting with a family history and requesting a test, for asymptomatic men requesting a test and also for men presenting with lower urinary tract symptoms. Reported testing rates were highest for men with a family history. Amongst men with lower urinary tract symptoms and men with no symptoms, reported testing rates were significantly higher for older than younger men. The majority of GPs expressed support for the current policy (67%), and favoured both the general practitioner and the man being involved in the decision making process (83%). 90% of GPs indicated that they would discuss the benefits and limitation of testing with the man, with most (61%) preferring to ask the man to make a further appointment if he decides to be tested.
  
  
  CONCLUSIONS
  This study indicates that PSA testing in asymptomatic men is a regular occurrence in the UK, and that there is general support from GPs for the current policy of making PSA tests available to 'informed' men who are concerned about prostate cancer. While most GPs indicated they would discuss the benefits and limitations prior to PSA testing, and most GPs favoured a shared approach to decision making, it is not known to what extent men are actually being informed. Research is needed to evaluate the most effective approach to assisting men in making an informed decision about whether or not to have a PSA test.
authors.affiliation: Cancer Research UK Primary Care Education Research Group, Department of Primary Health Care, Old Road Campus, University of Oxford, Headington, Oxford, OX3 7LF, UK. jo.brett@rcn.org.uk
authors.forename: Jo
authors.initials: J
authors.lastname: Brett
authors.forename: Eila
authors.initials: E
authors.lastname: Watson
authors.forename: Paul
authors.initials: P
authors.lastname: Hewitson
authors.forename: Colleen
authors.initials: C
authors.lastname: Bukach
authors.forename: Adrian
authors.initials: A
authors.lastname: Edwards
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
authors.forename: Joan
authors.initials: J
authors.lastname: Austoker
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003955:Diagnostic Tests, Routine; D004739:England; D005194:Family Practice / Q000193:education / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014852:Wales
chemical_list: D017430:Prostate-Specific Antigen