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19-05-2011 | General practice | Article

PSA test access uneven


Free abstract

Researchers have called for a review of current prostate-specific antigen (PSA) testing policy, after their study suggested that access to the tests is not based on clinical need.

The team found that GPs are far more likely to give PSA tests to elderly men and those living in affluent areas, indicating that the policy that enables all men to make an informed choice about PSA testing "is not being effectively implemented."

Using 2007 data for 126,716 men aged 45-89 years registered at 87 general practices in the UK, Chris Metcalfe (Bristol University, UK) and colleagues calculated PSA test rates and assessed how they are influenced by socioeconomic factors.

In all, 6.2% men received at least one PSA test, and a strong positive association was observed between testing and age, with testing rates increasing from 1.4% among men aged 45-49 years to 11.3% in men aged 75-79 years.

Testing rates were also lower in clinics in the three northern centres (3.5-5.7% in Newcastle, Sheffield and Leeds) than in the southern ones (7.1-8.9% in Leicester, Bristol and Cambridge).

Areas with more socioeconomic deprivation also exhibited lower rates of PSA testing. For every 20-point increase in the index of multiple deprivation score -incorporating income, employment, and education levels in the locality - the proportion of PSA-tested men in the cohort fell by 1.7%.

The variations in those who receive a PSA test "do not appear to reflect clinical need or the intention of current policy," conclude Metcalfe et al.

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Sarah Guy