Brief report: Free prostate-specific antigen test utilization. Consistency with guidelines.
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.


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


METHODS
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.
Jackson
Brian R
BR
Department of Pathology, University of Utah, Salt Lake City, Utah, USA. brian.jackson@aruplab.com
Roberts
William L
WL
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies
D017430:Prostate-Specific Antigen