A growing number of GPs will not initiate discussion of
prostate-specific antigen (PSA) testing with male patients,
research published yesterday in the New Zealand Medical
Study authors Simon van Rij, a registrar at Wellington
Hospital's urology department, and
Tony Dowell and John Nacey, both of the University of Otago
(Wellington), sent questionnaires to 1000 GPs and audited PSA
tests from 2011.
The study found 28% of men aged over 40 had a PSA test in
2011, which was comparable to other developed countries. PSA
cancer screening is controversial because of concerns it
leads in some cases to over-diagnosis and over-treatment.
''There is an increasing population of GPs who will not
initiate any discussion of PSA testing in their male
patients,'' the study said.
In 2011, 334,100 PSA tests were prescribed by New Zealand
GPs. Of the 931,923 men in New Zealand older than 40, more
than 267,000 had a PSA test.
Of the 263 GPs who responded, 79% would initiate discussion
of a PSA test with an asymptomatic patient.
GPs were more likely to initiate a screening in men under the
age of 50, with a family history of prostate cancer. Many
were influenced by concerns about possible over-treatment.
GPs were asked if their PSA screening habits had changed in
the past two years. While 65% felt there had been no change,
12% were testing less.
A decade ago, a GP survey found 97.5% performed some form of
''Our results show an increasing number of GPs who are not
performing this test compared to this previous research.
''Since this first questionnaire was published almost 10
years ago, the evidence around prostate cancer and PSA
screening has changed dramatically.''
Two large trials in the past 10 years had returned
conflicting results about whether the screening was