Prostate cancer screening, are we there yet? Results from the largest UK community-based PSA screening event
Al-Hammouri T1, Charlesworth P1, Jones A1, Blick C1 1Royal Berkshire Hospital NHS Foundation Trust, Reading, United Kingdom
Introduction: The role of PSA screening in the era of multiparametric MRI and modern prostate biopsy techniques remains undefined. This study used data from the UK's single largest PSA screening event to evaluate the clinical and economic effects of PSA screening in a contemporary cohort.
Patients and Methods: A total of 2235 men between the ages of 39-89 years attended on a single day for a PSA blood test organized by the Lions club in Reading, UK. Patients with borderline PSA results were told to have a repeat test, and those with abnormal results were referred to their local urology department. Clinical and financial data regarding subsequent investigations and treatment were collected retrospectively and analysed.
Results: All 2235 men underwent PSA testing, 2033 (91%) had a normal age specific PSA, 74 (3.3%) men were borderline and 128 (5.7%) had abnormal results. A total of 111 men were investigated further. Forty men were diagnosed with prostate cancer, 32 were ISUP ≥2 (1.4%). Subsequently, 13 patients had robotic radical prostatectomy, 15 had radical radiotherapy, 2 brachytherapy and 1 had hormone therapy. Based on analysis of clinical time and investigations costs, this screening program cost £210,386 equating to £103.5/person screened.
Conclusion: The role of PSA screening in the era of MPMRI and contemporary biopsy techniques needs to be revisited. The early diagnosis of prostate cancer increases the chance of curative treatment for clinically significant, treatable disease and is associated with similar cost per diagnosis to those of other current UK screening programmes.
Prostate cancer screening, are we there yet? Results from the largest UK community-based PSA screening event
Al-Hammouri T1, Charlesworth P1, Jones A1, Blick C1 1Royal Berkshire Hospital NHS Foundation Trust, Reading, United Kingdom
Introduction: The role of PSA screening in the era of multiparametric MRI and modern prostate biopsy techniques remains undefined. This study used data from the UK's single largest PSA screening event to evaluate the clinical and economic effects of PSA screening in a contemporary cohort.
Patients and Methods: A total of 2235 men between the ages of 39-89 years attended on a single day for a PSA blood test organized by the Lions club in Reading, UK. Patients with borderline PSA results were told to have a repeat test, and those with abnormal results were referred to their local urology department. Clinical and financial data regarding subsequent investigations and treatment were collected retrospectively and analysed.
Results: All 2235 men underwent PSA testing, 2033 (91%) had a normal age specific PSA, 74 (3.3%) men were borderline and 128 (5.7%) had abnormal results. A total of 111 men were investigated further. Forty men were diagnosed with prostate cancer, 32 were ISUP ≥2 (1.4%). Subsequently, 13 patients had robotic radical prostatectomy, 15 had radical radiotherapy, 2 brachytherapy and 1 had hormone therapy. Based on analysis of clinical time and investigations costs, this screening program cost £210,386 equating to £103.5/person screened.
Conclusion: The role of PSA screening in the era of MPMRI and contemporary biopsy techniques needs to be revisited. The early diagnosis of prostate cancer increases the chance of curative treatment for clinically significant, treatable disease and is associated with similar cost per diagnosis to those of other current UK screening programmes.
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