Unravelling the prostate-specific antigen controversy: a West of Scotland perspective.
BACKGROUND
The use of serum prostate-specific antigen (PSA) as a screening tool for prostate cancer in asymptomatic men is hugely controversial in the light of randomised controlled trials failing to demonstrate a benefit without risk of significant overtreatment. However, PSA can be used as a tool to risk assess disease progression in men with lower urinary tract symptoms suggestive of benign prostatic enlargement (LUTS/BPE). The aim of this study was to canvas the opinions of West of Scotland Urologists regarding the use of PSA in both symptomatic and asymptomatic patients.


METHODS
A questionnaire-based survey was sent to all the Consultants and Trainees in the West of Scotland.


RESULTS
Survey response rate was 45% (47/105). In patients <70 years, 93% would perform a PSA testing in patients symptomatic of LUTS/BPE, but only 17% would offer PSA screening to asymptomatic patients. In patients >70 years, only 48% of urologists would perform a PSA if patients were symptomatic and none would offer PSA screening. In terms of self-testing, 59% of urologists would have a PSA test if symptomatic and 31% of urologists would have PSA screening.


CONCLUSIONS
This study highlights significant variability in the use of PSA for both asymptomatic and symptomatic men. Despite a lack of evidence, PSA screening is still offered to asymptomatic men. Further randomised studies are required to determine the utility of PSA-based screening algorithms for prostate cancer detection.
['Zafar|Nauman|N|', 'Miller|Steve|S|', 'Leburn|Vicki|V|', 'Qureshi|Khaver N|KN|', 'Rajan|Prabhakar|P|']
D055088:Early Detection of Cancer D006801:Humans D059411:Lower Urinary Tract Symptoms D008297:Male D008403:Mass Screening D008875:Middle Aged D017430:Prostate-Specific Antigen D011471:Prostatic Neoplasms D018570:Risk Assessment D012606:Scotland D011795:Surveys and Questionnaires D014572:Urology
Prostate-specific Antigen prostate cancer guidelines prostate cancer screening prostate cancer treatment