Prostate specific antigen testing policy worldwide varies greatly and seems not to be in accordance with guidelines: A systematic review - Abstract

BACKGROUND: Prostate specific antigen (PSA) testing is widely used, but guidelines on follow-up are unclear.

METHODS: We performed a systematic review of the literature to determine follow-up policy after PSA testing by general practitioners (GPs) and non-urologic hospitalists, the use of a cut-off value for this policy, the reasons for repeating a PSA test after an initial normal result, the existence of a general cut-off value below which a PSA result is considered normal, and the time frame for repeating a test.

DATA SOURCES: MEDLINE, Embase, PsychInfo and the Cochrane library from January 1950 until May 2011.Study eligibility criteria. Studies describing follow-up policy by GPs or non-urologic hospitalists after a primary PSA test, excluding urologists and patients with prostate cancer and studies written in Dutch, English, French, German, Italian or Spanish were included. Excluded were studies describing follow-up policy by urologists and follow-up of patients with prostate cancer. The quality of each study was structurally assessed.

RESULTS: Fifteen articles met the inclusion criteria. Three studies were of high quality. Follow-up differed greatly both after a normal and an abnormal PSA test result. Only one study described the reasons for not performing follow-up after an abnormal PSA result.

CONCLUSIONS: Based on the available literature, we cannot adequately assess physicians' follow-up policy after a primary PSA test. Follow-up after a normal or raised PSA test by GPs and non-urologic hospitalists seems to a large extent not in accordance with the guidelines.

Written by:
van der Meer S, Löwik SA, Hirdes WH, Nijman RM, van der Meer K, Hoekstra-Weebers JE, Blanker MH.   Are you the author?

Reference: BMC Fam Pract. 2012 Oct 11;13(1):100.
doi: 10.1186/1471-2296-13-100

PubMed Abstract
PMID: 23052017 Prostate Cancer Section