Using the PSA test in general practice – how should we approach testing in asymptomatic men?

Today, we’re speaking to Dr Sam Merriel, a GP, and NIHR Academic Clinical Lecturer in General Practice based at the University of Manchester.Title of paper: Factors affecting prostate cancer detection through asymptomatic PSA testing in primary care in England: Evidence from the 2018 National Cancer Diagnosis AuditAvailable at: https://doi.org/10.3399/BJGP.2024.0376Asymptomatic, informed choice prostate specific antigen (PSA) testing occurs in primary care in the UK in the absence of a national prostate cancer screening programme. This study shows that four fifths of prostate cancers are diagnosed following symptomatic presentation rather than from asymptomatic PSA testing. There is a 13-fold variation in asymptomatic PSA test detected prostate cancer between English GP practices, without clear explanatory practice-level factors. Patient factors amongst men diagnosed with prostate cancer, including ethnicity, age, deprivation, and multi-morbidity, have a significant impact on the likelihood of being diagnosed following asymptomatic PSA testing.