title: Impact of the European Randomized Study of Screening for Prostate Cancer (ERSPC) on prostate-specific antigen (PSA) testing by Dutch general practitioners.
abstract: OBJECTIVE
  To determine the impact of the European Randomized Study of Screening for Prostate Cancer (ERSPC) publication in 2009 on prostate-specific antigen (PSA) level testing by Dutch general practitioners (GPs) in men aged ≥40 years.
  
  
  METHODS
  Retrospective study with a Dutch insurance company database (containing PSA test claims) and a large district hospital-laboratory database (containing PSA-test results). The difference in primary PSA-testing rate as well as follow-up testing before and after the ERSPC was tested using the chi-square test with statistical significance at P < 0.05.
  
  
  RESULTS
  Decline in PSA tests 4 months after ERSPC publication, especially for men aged ≥60 years. Primary testing as well as follow-up testing decreased, both for PSA levels of <4 ng/mL as well as for PSA levels of 4-10 ng/mL. Follow-up testing after a PSA level result of >10 ng/mL moderately increased (P = 0.171). Referral to a urologist after a PSA level result of >4 ng/mL decreased slightly after the ERSPC publication (P = 0.044).
  
  
  CONCLUSIONS
  After the ERSPC publication primary PSA testing as well as follow-up testing decreased. Follow-up testing seemed not to be adequate after an abnormal PSA result. The reasons for this remain unclear.
authors: Department of Urology, Isala Clinics, Zwolle, the Netherlands.
authors: Saskia
authors: S
authors: Van der Meer
authors: Boudewijn J
authors: BJ
authors: Kollen
authors: Willem H
authors: WH
authors: Hirdes
authors: Martijn G
authors: MG
authors: Steffens
authors: Josette E H M
authors: JE
authors: Hoekstra-Weebers
authors: Rien M
authors: RM
authors: Nijman
authors: Marco H
authors: MH
authors: Blanker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis* / Q000276:immunology; D014408:Biomarkers, Tumor / Q000032:analysis / Q000276:immunology; D055088:Early Detection of Cancer; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D011467:Prostate / Q000276:immunology*; D017430:Prostate-Specific Antigen / Q000276:immunology*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D012189:Retrospective Studies
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen