The health care sector is a significant contributor to greenhouse gas (GHG) emissions, and assessments of the environmental impacts of health services are essential. We aimed to evaluate the environmental impact of a highly common but controversial urology-specific blood test: the prostate-specific antigen (PSA) test.
A cradle-to-grave life cycle assessment was performed to estimate the emissions of a single PSA test. Primary data collection included laboratory site assessment, disassembly, and weighing of materials. The primary outcome was GHG emissions in grams of carbon dioxide equivalent (CO2e). The secondary outcome was the health impact attributed to the environmental harm of the test.
A single PSA test generates an estimated total of 189.7 g of CO2e. The majority of emissions (88.2%) were generated by the raw materials, manufacturing, production, and disposal of the blood draw equipment. Annual CO2e emissions from PSA testing in the USA were estimated at 5 691 000 kg CO2e, equivalent to driving 14.5 million miles, with a resulting human health impact of 6.6 disability-adjusted life years annually. This study focused on the PSA test itself, and not on emissions from staff, patient, or sample transportation; building infrastructure; or cleaning.
Although the carbon footprint of a single PSA test is small, the cumulative impact of the estimated total of 30 million PSA tests performed annually in the USA is substantial, especially when considering that a notable proportion of these tests may be performed on men who are unlikely to benefit.
European urology focus. 2025 Aug 01 [Epub ahead of print]
Hanna Zurl, Stephan M Korn, Klara K Pohl, Zhiyu Qian, Andrea Piccolini, Hari S Iyer, Michael S Leapman, Sascha Ahyai, Shahrokh F Shariat, Quoc-Dien Trinh, Cassandra L Thiel, Stacy Loeb, Alexander P Cole
Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Urology, Medical University of Graz, Graz, Austria., Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Urology, Humanitas Clinical and Research Hospital, Milan, Italy., Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA., Department of Urology, Yale School of Medicine, New Haven, CT, USA., Department of Urology, Medical University of Graz, Graz, Austria., Department of Urology, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Division of Urology, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern Medical Centre, Dallas, TX, USA., Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA., Department of Population Health, New York University Langone Health, New York, NY, USA., Department of Population Health, New York University Langone Health, New York, NY, USA; Department of Urology, New York University Langone Health and Manhattan Veterans Affairs, New York, NY, USA., Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: .