The number of tPSA tests continues to rise and variation in testing practices persists: a survey of laboratory services in Ireland 2008-2010.
BACKGROUND
Ireland had the highest incidence of prostate cancer in Europe in 2008, due to widespread prostate specific antigen (PSA) testing.


OBJECTIVE
To investigate practices and costs of PSA testing in Ireland, 2008-2010.


METHODS
Postal laboratory questionnaire. Results were compared with 2006 and 2007 surveys.


RESULTS
Response rate was 95 % (42/44). In 2010, 37 laboratories measured total PSA (tPSA); 10 measured free PSA (fPSA). Eight assays were used and cut-offs to define 'normal' tPSA varied widely. There was a 9.9 % annual increase in the number of tPSA tests and a -31 % annual decrease in the number of fPSA, 2006-2010. A 100-fold difference in tPSA workload was observed across laboratories. In 2010, the estimated cost of PSA testing was <euro>3,649,984 (95 % CI <euro>2,532,745-<euro>4,767,222).


CONCLUSIONS
Health service costs of PSA testing are significant. The number of tPSA tests continues to rise; fPSA use fell by almost one-third. Inter-laboratory variation in testing practices persists. These have potentially important clinical consequences for men and need to be addressed.
National Cancer Registry Ireland, Building 6800, Airport business Park, Kinsale Road, Cork, Ireland, f.drummond@ncri.ie.
F J
FJ
Drummond
E
E
Barrett
R
R
Burns
C
C
O'Neill
L
L
Sharp
D000328:Adult; D064790:Clinical Laboratory Services / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D003625:Data Collection; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016526:Workload
D017430:Prostate-Specific Antigen