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Published in: Irish Journal of Medical Science (1971 -) 4/2008

01-12-2008 | Original Article

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

Authors: F. J. Drummond, L. Sharp, H. Comber

Published in: Irish Journal of Medical Science (1971 -) | Issue 4/2008

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Abstract

Background

Ireland had the highest prostate cancer incidence in Europe in 2006. In that year, the National Cancer Forum (NCF) recommended against prostate specific antigen (PSA) testing for population-based screening.

Aims

To investigate (1) PSA services and (2) impact of the NCF recommendation.

Methods

Questionnaires were dispatched to biochemistry laboratories nationwide in 2006 and 2007.

Results

All 55 laboratories responded in 2006; 33/36 (89%) responded in 2007. 36 laboratories measured total PSA (tPSA); 14 measured free PSA (fPSA). Laboratories with higher tPSA workload were more likely to measure fPSA (P = 0.024). A total of 15 laboratories used age-specific PSA ranges. In 2006, there were >382,000 tPSA and >48,000 fPSA tests costing an estimated €4,900,000. During 2006–2007 tPSA tests increased by 11%; fPSA tests decreased by 36%.

Conclusions

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.
Literature
1.
go back to reference Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108 Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108
4.
go back to reference Drummond FJ, Sharp L, Carsin A-E, Deady S, Comber H (2007) PSA testing and prostate cancer diagnosis in the Republic of Ireland. BJU Int 100(Suppl):3;23 Drummond FJ, Sharp L, Carsin A-E, Deady S, Comber H (2007) PSA testing and prostate cancer diagnosis in the Republic of Ireland. BJU Int 100(Suppl):3;23
8.
go back to reference Oesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA et al (1993) Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA 270:860–864. doi:10.1001/jama.270.7.860 PubMedCrossRef Oesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA et al (1993) Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA 270:860–864. doi:10.​1001/​jama.​270.​7.​860 PubMedCrossRef
11.
go back to reference Ilic D, O’Connor D, Green S, Wilt T (2006) Screening for prostate cancer. Cochrane Database Syst Rev 3:CD004720 Ilic D, O’Connor D, Green S, Wilt T (2006) Screening for prostate cancer. Cochrane Database Syst Rev 3:CD004720
12.
go back to reference Onur R, Ilhan N, Orhan I, Ilhan N (2003) Increased discrimination between benign prostatic hyperplasia and prostate cancer with equimolar total prostate specific antigen measurement. World J Urol 21(1):43–47PubMed Onur R, Ilhan N, Orhan I, Ilhan N (2003) Increased discrimination between benign prostatic hyperplasia and prostate cancer with equimolar total prostate specific antigen measurement. World J Urol 21(1):43–47PubMed
13.
go back to reference Roddam AW, Price CP, Allen NE, Ward AM (2004) Assessing the clinical impact of prostate-specific antigen assay variability and nonequimolarity: a simulation study based on the population of the United Kingdom. Clin Chem 50(6):1012–1016. doi:10.1373/clinchem.2004.031138 PubMedCrossRef Roddam AW, Price CP, Allen NE, Ward AM (2004) Assessing the clinical impact of prostate-specific antigen assay variability and nonequimolarity: a simulation study based on the population of the United Kingdom. Clin Chem 50(6):1012–1016. doi:10.​1373/​clinchem.​2004.​031138 PubMedCrossRef
15.
go back to reference Bock JL, Klee GG (2004) How sensitive is a prostate-specific antigen measurement? How sensitive does it need to be? Arch Pathol Lab Med 128:341–343PubMed Bock JL, Klee GG (2004) How sensitive is a prostate-specific antigen measurement? How sensitive does it need to be? Arch Pathol Lab Med 128:341–343PubMed
16.
go back to reference Mistry K, Cable G (2003) Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract 16:95–101PubMedCrossRef Mistry K, Cable G (2003) Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract 16:95–101PubMedCrossRef
18.
go back to reference Catalona WJ, Partin AW, Slawin KM, Brawer MK, Flanigan RC, Patel A et al (1998) Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA 279:1542–1547. doi:10.1001/jama.279.19.1542 PubMedCrossRef Catalona WJ, Partin AW, Slawin KM, Brawer MK, Flanigan RC, Patel A et al (1998) Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA 279:1542–1547. doi:10.​1001/​jama.​279.​19.​1542 PubMedCrossRef
19.
go back to reference Catalona WJ, Partin AW, Finlay JA, Chan DW, Rittenhouse HG, Wolfert RL et al (1999) Use of percentage of free prostate-specific antigen to identify men at high risk of prostate cancer when PSA levels are 2.51 to 4 ng/mL and digital rectal examination is not suspicious for prostate cancer: an alternative model. Urology 54:220–224. doi:10.1016/S0090-4295(99)00185-5 PubMedCrossRef Catalona WJ, Partin AW, Finlay JA, Chan DW, Rittenhouse HG, Wolfert RL et al (1999) Use of percentage of free prostate-specific antigen to identify men at high risk of prostate cancer when PSA levels are 2.51 to 4 ng/mL and digital rectal examination is not suspicious for prostate cancer: an alternative model. Urology 54:220–224. doi:10.​1016/​S0090-4295(99)00185-5 PubMedCrossRef
20.
22.
go back to reference Sokoll LJ, Bruzek DJ, Dua R, Dunn W, Mohr P, Wallerson G et al (2002) Short-term stability of the molecular forms of prostate-specific antigen and effect on percent complexed prostate-specific antigen and percent free prostate-specific antigen. Urology 60((4)(Suppl 1)):24–30. doi:10.1016/S0090-4295(02)01723-5 PubMedCrossRef Sokoll LJ, Bruzek DJ, Dua R, Dunn W, Mohr P, Wallerson G et al (2002) Short-term stability of the molecular forms of prostate-specific antigen and effect on percent complexed prostate-specific antigen and percent free prostate-specific antigen. Urology 60((4)(Suppl 1)):24–30. doi:10.​1016/​S0090-4295(02)01723-5 PubMedCrossRef
24.
go back to reference Drummond FJ, Comber H (2007) PSA testing–weighing up the evidence. Forum. Clin Focus 7:15–18 Drummond FJ, Comber H (2007) PSA testing–weighing up the evidence. Forum. Clin Focus 7:15–18
26.
go back to reference McGing PG (1998) A study of PSA requests from general practitioners received by one Dublin hospital. Ir Med J 91:61–62PubMed McGing PG (1998) A study of PSA requests from general practitioners received by one Dublin hospital. Ir Med J 91:61–62PubMed
29.
go back to reference Colditz GA, Emmons KM, Vishwanath K, Kerner JF (2008) Translating science to practice: community and academic perspectives. J Public Health Manag Pract 14:144–149PubMed Colditz GA, Emmons KM, Vishwanath K, Kerner JF (2008) Translating science to practice: community and academic perspectives. J Public Health Manag Pract 14:144–149PubMed
30.
go back to reference Kerner JF (2008) Integrating research, practice, and policy: what we see depends on where we stand. J Public Health Manag Pract 14:193–198PubMed Kerner JF (2008) Integrating research, practice, and policy: what we see depends on where we stand. J Public Health Manag Pract 14:193–198PubMed
31.
go back to reference Connolly D, Black A, Gavin A, Keane PF, Murray LJ (2008) Baseline prostate-specific antigen level and risk of prostate cancer and prostate-specific mortality: diagnosis is dependent on the intensity of investigation. Cancer Epidemiol Biomarkers Prev 17:271–278. doi:10.1158/1055-9965.EPI-07-0515 PubMedCrossRef Connolly D, Black A, Gavin A, Keane PF, Murray LJ (2008) Baseline prostate-specific antigen level and risk of prostate cancer and prostate-specific mortality: diagnosis is dependent on the intensity of investigation. Cancer Epidemiol Biomarkers Prev 17:271–278. doi:10.​1158/​1055-9965.​EPI-07-0515 PubMedCrossRef
Metadata
Title
Major inter-laboratory variations in PSA testing practices: results from national surveys in Ireland in 2006 and 2007
Authors
F. J. Drummond
L. Sharp
H. Comber
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
Irish Journal of Medical Science (1971 -) / Issue 4/2008
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-008-0216-1

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