Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Increased patient demand for prostate test has serious implications for cancer services

16.11.2006
Male patients are increasingly demanding PSA tests for prostate cancer, despite lack of evidence that they are effective, according to a survey of more than 700 family doctors published in the November issue of the urology journal BJU International.

Researchers from Queen’s University Belfast and the Eastern Health and Social Services Board discovered that more than two-thirds of doctors (65 per cent) said that they provided PSA tests on request.

They did this despite the fact that the UK National Health Service Executive and the UK’s National Screening Committee don’t recommend routine screening for prostate cancer, in the absence of symptoms, using PSA (Prostate Specific Antigen) blood tests.

“Increased on-demand PSA testing represents a major pressure on family doctors and has serious implications for prostate cancer investigation and treatment” says co-author Dr Jackie McCall, Specialist Registrar in Public Health Medicine at the Eastern Health and Social Services Board.

“Clinical evidence suggests that PSA testing may not improve survival or quality of life and might cause more harm than good, to patients and services alike."

The team surveyed all 1067 family doctor practices in Northern Ireland and matched their responses with a regional PSA testing database.

More than two-thirds of the doctors surveyed (704) responded to the postal questionnaire, which explored their personal profile, the profile of their practice and their PSA testing behaviour.

A detailed analysis of the results revealed that there were a range of complex factors that influenced whether family doctors carried out PSA screening. These included:

• 49 per cent of doctors were aware of the national guidelines for PSA testing, but that awareness did not influence testing levels.

• Tests were more likely to be ordered by full-time male doctors who had been practising for 21 to 30 years and by those who worked in rural practices.

• 13 per cent of doctors had held a postgraduate post in urology, but this did not affect their testing behaviour. And working in an accredited training practice was associated with lower testing levels.

• Opportunistic PSA testing is being carried out on men who consult their family doctor about unrelated complaints. 47 per cent of doctors reported that PSA testing had previously picked up prostate cancer in patients with no symptoms and 51 per cent said this influenced their practice.

• Doctors were also more likely to test men with a positive family history of prostate cancer.

• Only half a per cent of the doctors surveyed reported a specialist interest in male health, despite prostate cancer being the commonest male cancer and current drives to improve awareness of the disease in primary care.

Data from all the first PSA tests ordered by doctors during the survey period (2003-2004) were matched with the questionnaire responses and analysed to investigate their association with variables such as gender, age, location of practice and awareness of guidelines.

More than 15,000 PSA tests had been ordered – an average of 11 per doctor.

34 per cent of the respondents worked in an urban practice, 24 per cent in a rural setting and 42 per cent in a mixture of the two. Seven per cent worked on their own and 32 per cent had five or more partners.

“Our research shows that merely providing family doctors with guidance is not sufficient to influence patterns of PSA testing” adds co-author Dr Gerard Gormley, a Senior Lecturer in the Department of General Practice at the University. “They need better training in this area so that testing can be targeted more effectively and that patients can be kept better informed and counselled if testing is indicated.

“Finding out what makes family doctors carry out PSA tests is an important step in this process. Cutting the number of unnecessary PSA tests carried out by family doctors will lead to more effective referrals and this will play a key role in reducing hospital waiting lists so that urgent cases receive the priority they deserve.”

BJU International’s editor Professor John Fitzpatrick, from University College Dublin, Ireland, says that that the paper makes an important contribution to the ongoing debate on PSA screening. "This is an excellent study which looks scientifically at the problems that may develop in the UK with the increase in PSA screening" he says.

Annette Whibley | alfa
Further information:
http://www.bjui.org

More articles from Health and Medicine:

nachricht Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University

nachricht Direct conversion of non-neuronal cells into nerve cells
03.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Research finds new molecular structures in boron-based nanoclusters

13.07.2018 | Materials Sciences

Algae Have Land Genes

13.07.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>