title: The patient perspective on a first raised PSA test.
abstract: BACKGROUND
  Approximately 350 000 prostate-specific antigen (PSA) tests are undertaken in New Zealand on a quarter of a million men each year. A number of studies have looked at PSA testing done by general practitioners (GPs) and subsequent outcomes. Few have looked at the patient perspective after a raised PSA result.
  
  
  OBJECTIVE
  To explore patient experiences up to and following a raised PSA test.
  
  
  METHODS
  Thirty-one general practices within the Midland region were recruited. Community laboratory databases were used to identify all men with a first raised PSA test during 2010. Questionnaires were sent to these men.
  
  
  RESULTS
  One hundred and ninety-four (63%) eligible responses were received from 307 eligible men delivered questionnaires. For 54% of men this was their first PSA test. Most men (66%) identified that their PSA test was initiated by their GP. Forty-three percent of men identified having symptoms at the time of their first raised PSA test. A digital rectal examination (DRE) was performed on 73% of men at the time of the test. Fifty-eight percent of men were referred to see a specialist. Maori men were less likely to be referred after a raised PSA. Of all men referred, 61% received a biopsy.
  
  
  CONCLUSIONS
  PSA testing is predominantly initiated by GPs. We found the care pathway is variable for men after an elevated PSA result. Standardisation of the pathway prior to and post diagnosis would assist patients in knowing what to expect and would aid in GP management of men being investigated for prostate cancer.
authors.affiliation: The University of Auckland, Waikato Clinical Campus, Peter Rothwell Academic Centre, PB 3200, Hamilton 3240, New Zealand. charis.brown@auckland.ac.nz.
authors.forename: Charis
authors.initials: C
authors.lastname: Brown
authors.affiliation: The University of Auckland, Waikato Clinical Campus, Peter Rothwell Academic Centre, Hamilton, New Zealand.
authors.forename: Fraser
authors.initials: F
authors.lastname: Hodgson
authors.affiliation: The University of Auckland, Waikato Clinical Campus, Peter Rothwell Academic Centre, Hamilton, New Zealand.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Obertova
authors.affiliation: Waikato Hospital, Urology Services Limited, Hamilton, New Zealand.
authors.forename: Michael
authors.initials: M
authors.lastname: Holmes
authors.affiliation: The University of Auckland, Waikato Clinical Campus, Peter Rothwell Academic Centre, Hamilton, New Zealand.
authors.forename: Ross
authors.initials: R
authors.lastname: Lawrenson
mesh_terms: D000368:Aged; D051517:Digital Rectal Examination; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data*; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology*
chemical_list: D017430:Prostate-Specific Antigen