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Optimising the value of PSA testing

Screening for prostate cancer with PSA testing has always been a bit controversial. Initially the high rate of false positives, especially in younger men, had most GPs questioning whether overall, we were doing more harm than good. But it would seem we’ve come a long way since those early days.

Not only do we understand a lot more about the PSA test itself, but also, we now are better able to determine what an elevated PSA signifies in a particular patient through tools such as imaging, before subjecting the man to a series of invasive procedures.

There was a time when different authoritative bodies were giving different advice as to how this screening should be conducted and how any abnormalities should managed.

Fortunately now we can refer to one set of guidelines that seems to have been endorsed by all the major players.

The current PSA guidelines are provided on the Cancer Council website, and represent a consensus of opinion as to what the evidence proposes is best practice with regard this screening blood test. The guidelines have been endorsed by all the relevant organisations including the RACGP and the Urological Society of Australia and New Zealand (USANZ).

The guidelines highlight the fact that when it comes to PSA, it is the absolute value and trend that is important – not velocity. The guidelines are very comprehensive and very easy to navigate. All those awkward questions  such as how to manage an equivocal result and where does DRE fit in are all here. Very reassuring for those GPs  keen on adopting best practice techniques.

 

>> Access the resource here