Major inter-laboratory variations in PSA testing practices: results from national surveys in Ireland in 2006 and 2007

Abstract

There is considerable inter-laboratory variation in PSA testing practices. Because of the potential clinical consequences, standardisation should be considered. Testing practice was unaffected by the NCF recommendation.

Discussions About Prostate Cancer Screening Between U.S. Primary Care Physicians and Their Patients

“…In an international study of general practitioners, the likelihood of physicians screening their patients for prostate cancer was associated with being older, having practiced longer, being female, and being less knowledgeable about PSA efficacy. 20 In our study, in addition to finding the likelihood that PCPs would discuss prostate cancer screening with their patients (first outcome) to be associated with PCP race, we also found it to be positively associated with weekly patient volume, self-perception of knowledge about the screening guidelines, and type of practice of the PCP. This suggests the importance of both individual and practice-level factors in prostate cancer screening practices among PCPs.…”

Trends in prostate specific antigen testing in Ireland: lessons from a country without guidelines

“…The level of testing in Ireland is now much higher than that observed in the UK where approximately 6% of men aged 50 years and older had a test annually in Northern Ireland [15] and in other parts of the UK [16,17]. In a survey of laboratories in Ireland undertaking PSA testing, we found that urologists' practice has a major influence on PSA testing [11]. We further found, in a survey of urologists themselves, that more than half (56%) of urologists working in Ireland in 2005 had either worked or completed part of their training in the US and 82% worked or trained in the UK [20].…”

“…The number of PSA tests performed for the entire study period was estimated to be 60% complete. To calculate the age-standardised rates of PSA testing by year, nationwide, a weight correction was applied based on a national survey of PSA services in Ireland [11]. Each laboratory was asked how many PSA measurements were performed in the first 3 months of 2006 and in what year they began measuring PSA [11].…”

Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland

“…Individual-level data for all tests performed in each year were sought, but not all laboratories could provide this. To estimate the annual numbers of tests nationally, we allocated a weight to each laboratory by year based on the number of PSA tests they reported performing in the first quarter of 2006 and the year they started measuring PSA [14]. Comparing these numbers with the individual-level data provided, we estimated that we collected information on 58% of the total number of tests conducted during 1994-2005.…”

“…PSA testing is used extensively in primary care in the RoI, but there are wide variations in practice, likely to be due in part to a lack of national guidelines [14]. The RoI has a mixed public-private health care system, with the majority of visits to primary care incurring a charge to the patient.…”