Trends in prostate specific antigen testing in Ireland: lessons from a country without guidelines
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Prostate specific antigen (PSA) testing is associated with increased prostate cancer (PCa) incidence. Ireland has no national guidelines on PCa screening and had the highest PCa incidence in Europe, 2006.
To investigate trends in PSA testing in Ireland.
Data on PSA tests, 1994–2005, was collated.
Age-standardised rates of PSA testing increased 39 and 25% annually in men <50 and ≥50 years, respectively. Most tests were performed in men 50–69 years; 26 and 22% were performed in men <50 and ≥70 years, respectively. Baseline PSA tests peaked in 2004, at 16% of men. 83% of baseline tests were <4.0 ng/ml. Repeat testing increased with age and PSA level (P < 0.001); men <50 years and with levels <4.0 ng/ml had >1 tests in <21 months. PCa incidence increased 9% annually, 1994–2005.
Uptake of PSA testing was rapid: increased use was simultaneous with increased PCa incidence. National guidelines are needed to manage this important public health issue.
KeywordsPSA Prostate specific antigen Prostate cancer Incidence Mortality Screening Guidelines
This work could not have been done without the help of numerous people in the hospital system-scientists, IT specialists and doctors—too numerous to mention. Funding was from the Health Research Board, Ireland and the National Cancer Screening Service.
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