Key Summary
- Oxford study found PSA testing for prostate cancer is being overused, often in men without symptoms
- Researchers warned unregulated testing causes harm and high costs with little benefit
- They called for updated NICE guidance to better target testing and care
A study by Oxford University has found that men are getting over-tested for prostate cancer, while those needing care may be getting overlooked.
In the study published in the British Medical Journal, the researchers examined the records of more than 10 million men in England, and found they are being given prostate specific antigen (PSA) tests far more than recommended.
They also found that repeat testing was being done for patients without symptoms, or whose previous tests suggest low levels of risk.
Prostate is one of the common cancers found in nearly 55,300 men annually in the UK.
The opinion is divided over PSA tests, with some saying all men should be tested at regular intervals, while others argue it is unreliable.
The study pointed out that PSA levels can rise for many reasons, including simple infections, and 75 percent of people with a raised PSA do not have prostate cancer.
Researchers noted that patients in their 70s were far more likely to be tested, and testing rates was higher for white men.
Overall, testing rates were two to three times higher in people without symptoms than in patients with symptoms, it added.
The researchers are worried that “unregulated PSA testing” will result in large costs and harms, and do little to identify prostate cancer.
NICE guidance advises active surveillance as the preferred approach for men who have the lowest-risk cancer.
But these guidelines have not been updated since 2021.
Researchers conclude there is a “need for better NICE guidance, especially in men outside of recommended ages or men with lower urinary tract symptoms, erectile dysfunction, or other conditions unrelated to prostate cancer”.
