Study Reveals Differences in Prostate Cancer Detection Rates Across General Practitioner Practices
A recent large-scale study has revealed significant disparities among GP practices in the United Kingdom regarding their likelihood of identifying prostate cancer through blood tests. Led by the University of Exeter, this investigation aimed to examine how many patients with prostate cancer were diagnosed using a prostate-specific antigen (PSA) test without any symptoms present. The findings, published in the British Journal of General Practice and supported by Cancer Research UK, suggest that only one in five men diagnosed with prostate cancer through PSA testing did so without showing symptoms—lower than previously anticipated.
The PSA test remains the sole available diagnostic tool for prostate cancer in the UK, where it has become the most common form of cancer, affecting over 55,000 new patients annually. While this test is regularly used when men exhibit urinary issues, there are differing opinions on its use for asymptomatic individuals. The UK National Screening Committee advises against a nationwide screening program using PSA tests due to unclear evidence regarding their benefits. Moreover, some prostate cancers detected through screening may not require treatment and could lead to complications like erectile dysfunction and incontinence.
However, men over the age of 50 are permitted by law to request a PSA test from their GP after being informed about its potential risks and advantages. The new study highlights substantial variations between GP practices across England concerning how often they diagnose asymptomatic prostate cancer using PSA testing. Despite these differences, no definitive cause for this inconsistency was identified in the research; however, it did find that men living in deprived areas are less likely to undergo screening and more prone to developing late-stage prostate cancer.
Professor Gary Abel from the University of Exeter, who conducted the study, expressed surprise at “the extent of variation we saw between practices,” indicating a lack of clear guidelines surrounding PSA testing for asymptomatic men. He also highlighted that consistent approaches are needed to address disparities in screening rates among different socio-economic groups.
The research team analyzed over 9,800 records from the 2018 English National Cancer Diagnosis Audit, which collected information on patients’ symptoms and the diagnostic tests they underwent. The audit asked GPs to review cancer diagnoses and record relevant details. Lead author Dr. Sam Merriel of Manchester University and a practicing GP pointed out that referral decisions for prostate cancer diagnosis are largely influenced by individual GPs due to inconsistencies in local, regional, and national guidance.
Dr. Merriel explained the complexities involved: “Inconsistencies may be contributing to the variation in how often GPs detect asymptomatic prostate cancer through PSA testing. This study highlights these variations, which can be particularly distressing for patients but are crucially influenced by evidence-based decisions.” He also acknowledged that while some men may seek a PSA test due to worry about potential health issues, current evidence suggests it could potentially cause more harm than good when there are no symptoms of prostate cancer.
Naser Turabi from Cancer Research UK emphasized the organization’s ongoing efforts to find better ways to detect and treat prostate cancer: “We’re determined to fund research that will improve our understanding and help save lives. The evidence is constantly reviewed, but at present, screening for asymptomatic men with PSA tests isn’t recommended in the UK.” This underscores the need for continued research and discussion around effective diagnostic methods for this prevalent form of cancer.
