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Huge jump in prostate screening

The number of men being tested for prostate specific antigen has rocketed in the last five years suggesting the policy of screening on demand has gone out of control, according to new research.

Experts said heightened public awareness throughout the UK had led to men flooding surgeries with high expectations about the test.

Data from the Northern Ireland Cancer Registry has shown GPs conducted some 165,862 prostate specific antigen (PSA) tests on 84,669 men over a five-year period, which equates to more than a third of men aged over 50.

PSA levels were 'raised' in more than 20,000 men leaving GPs with the huge task of counselling them about the risks associated with a biopsy and the false positive rates – Department of Health figures show just a third of men with raised PSA will have cancer.

Study lead Dr Anna Gavin, director of the registry, said the number of tests was rising year by year in Northern Ireland but with up to 100-fold variance in some parts.

She suggested some GPs might actually be offering the test to patients, contrary to guidelines telling GPs to only offer it if asked by over-50s.

She added: 'The situation is worrying. PSA tests don't meet the criteria for population-based screening. It's not that sensitive, there's a lot of debate about whether there's effective treatment, the natural progression of prostate cancer isn't known, and the test won't tell you whether it's slow or fast growing.'

Dr Jane Melia, project co-ordinator at the Cancer Screening Evaluation Unit in Surrey, who has been looking at PSA testing trends in England and Wales, said heightened public awareness had led to similar increases in the UK.

Dr James Kingsland, a member of the expert advisory group on prostate cancer screening and a GP in Wallasey, Liverpool, said there had been a 'dramatic' increase in the number of men asking for the test in his surgery.

He said: 'That's the power of the media. But all too often patients are not given good information and it takes a lot longer to explain why they should not have the test.'

Dr Peter Colvin, Northern Ireland RCGP chair and GP in Armagh, said: 'It would be regrettable if GPs were testing more than necessary but should a GP be criticised for responding to a genuine concern from the patient?'

By Emma Wilkinson

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