MADRID, Oct. 11 (EUROPA PRESS) –

Prostate cancer is one of the most common cancers among men worldwide, and early detection is essential to increase the chances of survival. The most commonly used tests include prostate specific antigen analysis and the physical examination through rectal examination, which allow alterations to be identified even before symptoms appear.

WHAT IS THE PSA TEST AND HOW DOES IT WORK?

The PSA test consists of a blood test that measures levels of prostate-specific antigen, a protein produced by the prostate that can indicate the presence of cancer or other prostate disorders.

However, these tests generate debate among experts, since they can produce false positives and lead to unnecessary treatments. Knowing how screening methods work, their advantages and limitations, as well as the importance of early diagnosis, is key to making informed decisions and improving long-term men’s health outcomes.

Current prostate-specific antigen (PSA) tests “may not target testing effectively to those most likely to benefit, raising concerns about the possibility of over-testing,” warn researchers from the University of Oxford (UK), in a study of more than 10 million men across England published by ‘The BMJ’.

Despite the recommendations of limit PSA testing to patients with symptoms or after discussing it with a primary care doctor, The results show that many patients are tested more frequently than recommended, and repeat testing is performed in patients with no recorded symptoms or with previously low PSA values.

The authors note that the findings reflect a lack of consistent international orientation and note that “unpredictable increases in PSA testing, overtesting, and associated costs” can occur as a result of celebrities publicly sharing their cancer diagnoses and advocating for screening.

FACTORS THAT INFLUENCE THE CONDUCT OF THE TEST

Therefore, researchers wanted to better understand How PSA tests are used in Primary Care in England before being diagnosed with prostate cancer. To do this, they relied on data from 10,235,805 men aged 18 years or older who were registered in 1,442 general practices across England between 2000 and 2018 and did not have a diagnosis of prostate cancer before entering the study.

Data were linked to the National Cancer Registry, Hospital Episode Statistics and the Office for National Statistics, and results were analyzed by region, deprivation, age, ethnicity, family history of prostate cancer, symptom presentation and PSA value.

A total of 1,521,116 men had at least one PSA test during the study periodresulting in a total of 3,835,440 PSA tests. Testing increased fivefold over the study period, especially in men without symptoms and those with PSA values ​​below recommended thresholds.

The highest testing rates were in men aged 70 and older, who are least likely to benefit from repeat testing, and a substantial portion were in men much younger (18-39 years) than recommended. Besides, Testing rates varied by regiondeprivation, ethnicity, family history, age, PSA value and symptoms; the highest rates were seen in patients of white ethnicity and in less deprived areas.

Almost half of the men (735,750) underwent a retest. Of these, more than 75% had no symptoms and 73% never had a PSA value higher than the recommended threshold. The average interval between tests was just over 12 months overall and 17 months for patients who had never had a PSA value above the recommended threshold (shorter than most guidelines recommend). After testing, patients had shorter repeat intervals if they were older, belonged to an ethnic group other than white, had a family history of prostate cancer, or had previously had a high PSA value.

RISKS OF OVERDETECTION AND REPEATED TESTING

The authors acknowledge that the routine use of primary care data has limitations.and that analyzes of intervals between tests were limited to patients with at least two PSA tests during follow-up, raising the possibility of bias. However, they say they thoroughly analyzed the PSA tests and the length of the intervals between the tests, and that the results were consistent after further analysis, suggesting their robustness.

“PSA testing in primary care is varied. Among patients who underwent multiple tests, many were tested more frequently than recommended, raising concerns about the possibility of over-testing. “New PSA tests are being performed on patients with no recorded symptoms or with previously low PSA values.”

“To ensure maximum patient benefit while reducing the risk of over-testing, research is urgently needed to determine appropriate evidence-based PSA retest intervals,” the researchers conclude.

Ultimately, the PSA test remains a valuable tool for detecting prostate cancer early and improving the chances of survival. However, its use must be prudent and personalizedfollowing medical and evidence-based recommendations. Avoiding excessive testing helps reduce false positives, anxiety and unnecessary treatments. Regular consultation with your doctor and assessing individual risk is key to making informed decisions and caring for long-term prostate health.