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The number of tPSA tests continues to rise and variation in testing practices persists: a survey of laboratory services in Ireland 2008–2010

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Abstract

Background

Ireland had the highest incidence of prostate cancer in Europe in 2008, due to widespread prostate specific antigen (PSA) testing.

Aims

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 €3,649,984 (95 % CI €2,532,745–€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.

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Acknowledgments

The authors would like to thank the consultant clinical biochemists, consultant chemical pathologists, laboratory managers, clinical biochemists and medical scientists who responded to this questionnaire. This study was funded by the Health Research Board (HRA-HSR/2009/17).

Conflict of interest

None.

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Authors and Affiliations

  1. National Cancer Registry Ireland, Building 6800, Airport business Park, Kinsale Road, Cork, Ireland

    F. J. Drummond & L. Sharp

  2. Mid Western Regional Hospital, Limerick, Ireland

    E. Barrett

  3. J.E. Cairnes School of Business and Economics, NUI Galway, Galway, Ireland

    R. Burns & C. O’Neill

Authors
  1. F. J. Drummond
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  2. E. Barrett
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  3. R. Burns
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  4. C. O’Neill
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  5. L. Sharp
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Corresponding author

Correspondence to F. J. Drummond.

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Drummond, F.J., Barrett, E., Burns, R. et al. The number of tPSA tests continues to rise and variation in testing practices persists: a survey of laboratory services in Ireland 2008–2010. Ir J Med Sci 183, 369–375 (2014). https://doi.org/10.1007/s11845-013-1022-y

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  • DOI: https://doi.org/10.1007/s11845-013-1022-y

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