title: PSA testing in general practice.
abstract: BACKGROUND
  In New Zealand, prostate-specific antigen (PSA) testing has increased significantly (275 000 tests/year). Controversy exists around PSA testing as part of an unorganised screening programme.
  
  
  OBJECTIVE
  To look at the use of PSA testing in a sample of general practices and investigate the reasons GPs undertake PSA testing.
  
  
  METHODS
  Five Waikato general practices investigated looking at PSA laboratory tests of men ≥40 years in 2010 compared against GP notes. Testing rates, reasons for testing, histology and referral/s were examined for different age groups. A questionnaire was sent to the GPs to determine their views on PSA testing.
  
  
  RESULTS
  One in four men aged 40+ years had a PSA test in 2010. Of these men, 71% were asymptomatic. More than half of men tested aged 70+ years were asymptomatic. Ten percent of all PSA tests were elevated. Twenty-one of 23 prostate cancers were diagnosed following an elevated PSA test: more than 80% of these men had histories of prostate pathology or lower urinary tract symptoms. The questionnaire confirmed that GPs believe in the benefits of PSA screening and it also showed they had difficulty in providing patients with information about pros and cons of PSA testing.
  
  
  CONCLUSIONS
  All GPs in this study tested asymptomatic men. GPs in this study value PSA screening and believe that it reduces mortality rates. However, although PSA tests were most frequently done on asymptomatic patients, the majority of patients subsequently diagnosed with prostate cancer had been tested because of symptoms or had previous prostate problems.
authors.affiliation: Waikato Clinical School, The University of Auckland, PB 3200, Hamilton, New Zealand. f.hodgson@auckland.ac.nz
authors.forename: Fraser
authors.initials: F
authors.lastname: Hodgson
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Obertová
authors.forename: Charis
authors.initials: C
authors.lastname: Brown
authors.forename: Ross
authors.initials: R
authors.lastname: Lawrenson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000517:prevention & control; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D017430:Prostate-Specific Antigen