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- Title
Optimising the use of the prostate- specific antigen blood test in asymptomatic men for early prostate cancer detection in primary care: report from a UK clinical consensus.
- Authors
Harding, Thomas A; Martin, Richard M; Merriel, Samuel WD; Jones, Robert; O'Sullivan, Joe M; Kirby, Mike; Olajide, Oluwabunmi; Norman, Alexander; Bhatt, Jaimin; Hulson, Oliver; Martins, Tanimola; Gnanapragasam, Vincent J; Aning, Jonathan; Burgess, Meg; Rosario, Derek J; Pashayan, Nora; Tesfai, Abel; Norori, Natalia; Rylance, Amy; Seggie, Andrew
- Abstract
Background: Screening is not recommended for prostate cancer in the UK. Asymptomatic men aged ≥50 years can request a prostate-specific antigen (PSA) test following counselling on potential harms and benefits. There are areas of clinical uncertainty among GPs, resulting in the content and quality of counselling varying. Aim: To produce a consensus that can influence guidelines for UK primary care on the optimal use of the PSA test in asymptomatic men for early prostate cancer detection. Design and setting: Prostate Cancer UK facilitated a RAND/UCLA consensus. Method: Statements covering five topics were developed with a subgroup of experts. A panel of 15 experts in prostate cancer scored (round one) statements on a scale of one (strongly disagree) to nine (strongly agree). Panellists met to discuss statements before rescoring (round two). A lived experience panel of seven men scored a subset of statements with outcomes fed into the main panel. Results: Of the initial 94 statements reviewed by the expert panel, a final 48/85 (56%) achieved consensus. In the absence of screening, there was consensus on proactive approaches to initiate discussions about the PSA test with men who were at higher-than-average risk. Conclusion: Improvements in the prostate cancer diagnostic pathway may have reduced some of the harms associated with PSA testing; however, several areas of uncertainty remain in relation to screening, including optimal PSA thresholds for referral and intervals for retesting. There is consensus on proactive approaches to testing in higher-than-average risk groups. This should prompt a review of current guidelines.
- Subjects
EARLY detection of cancer; PROSTATE cancer patients; PRIMARY health care; ASYMPTOMATIC patients; PROSTATE-specific antigen
- Publication
British Journal of General Practice, 2024, Vol 74, Issue 745, pe534
- ISSN
0960-1643
- Publication type
Article