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NICE guideline clarifies when to discuss PSA testing

By Lilian Anekwe

New NICE guidance on lower urinary tract symptoms (LUTS) in men has clarified when GPs should discuss prostate specific antigen (PSA) testing with patients.

The guidance, the first NICE has issued on LUTS, states GPs need only discuss PSA testing if symptoms are suggestive of bladder outlet obstruction secondary to benign prostate enlargement, or if the prostate feels abnormal during a digital rectal examination, or if they have other concerns about prostate cancer.

It also recommends GPs offer all men who present with symptoms an abdominal and genital examination. Men should also record their symptoms in a ‘bladder diary' and be offered a urine test and a digital rectal examination.

Dr Julian Spinks, a GP in Strood, Kent and a member of the guideline development group, said: ‘If men are concerned about prostate cancer it's right for GPs to discuss PSA testing in accordance with existing NICE guidance. Otherwise if they have an abnormal-feeling prostate GPs should raise the issue but not necessarily recommend the test.'

NICE guideline clarifies when to discuss PSA testing


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