New research lead by Oxford Cancer DPhil in Cancer Science student reveals significant variations in how prostate specific antigen (PSA) tests are used in English primary care, with many men being tested more frequently than recommended.
“PSA testing in primary care is varied,” says Kiana Collins, DPhil student and lead author based in the Nuffield Department of Primary Care Health Sciences. “Among patients who underwent multiple tests, many were tested more frequently than recommended, raising concerns about overtesting. PSA retesting is occurring in patients without recorded symptoms or with previous low PSA values.”
The study, published in The BMJ, analysed data from over 10 million men registered at GP practices across England between 2000 and 2018. The findings raise important questions about how PSA testing is being used and whether current approaches effectively target those most likely to benefit.
Almost half of those tested were retested at least once, yet more than 70% never had a PSA value above the age-specific threshold that would typically prompt a referral to specialist care. The median time between tests was around 12.5 months – shorter than most international guidance recommends, and much shorter than would be expected for lower-risk men.
Testing rates were highest in men aged 70 and older – a group least likely to benefit from repeat testing and most at risk of overdiagnosis. Researchers estimate that men in this age group account for around 40% of prostate cancer overdiagnoses.
Read the full story on the Nuffield Department of Primary Care Health Sciences website.