NHMRC Releases Resource Outlining Risks and Benefits of PSA Testing

To help inform discussions between health practitioners and their patients about the early detection of prostate cancer, the National Health and Medical Research Council (NHMRC) has released a resource outlining the risks and benefits of Prostate Specific Antigen (PSA) testing.
“It is important that health practitioners discuss both the potential benefits and harms of PSA testing with patients before ordering a PSA test,” NHMRC CEO Professor Warwick Anderson said. “This resource offers balanced, evidence-based information that health practitioners can use when discussing PSA testing with patients.”
This new information document, PSA Testing for Prostate Cancer in Asymptomatic Men: Information for Health Practitioners, was developed by a multidisciplinary expert advisory group with broad representation from disciplines including general practice, medical oncology, urology, pathology, public health, epidemiology, Aboriginal and rural health, and evidence-based practice. Consumers were also represented.
Public consultation for the information document closed on 20 August 2013 and all submissions have been considered.
The document was developed by NHMRC and funded by the Australian Government Department of Health, which also funded the underlying evidence review.
Key facts

• The PSA health resource was developed for health practitioners to read before they discuss the prostate-specific antigen (PSA) test as part of a medical consultation.


• For every 1000 men aged 60 years tested¹, it is estimated that:
  
  
  
  • 2 men will avoid death from prostate cancer before 85 years of age because of PSA testing.
  
  
  • 2 men will avoid metastatic prostate cancer before 85 years of age because of PSA testing.
  
  
  • 87 men who do not have prostate cancer will have a false positive PSA test that will lead to a biopsy.
  
  
  • 28 men will experience a side effect from the biopsy that they consider to be a moderate/major problem that may require healthcare.
  
  
  • 28 men will have prostate cancer diagnosed as a result of the PSA test, many of whom would have remained asymptomatic for life (i.e. are overdiagnosed).
  
  
  • 25 men will choose to undergo treatment (surgery or radiation) because of uncertainty about which cancers need to be treated, many of whom would do well without treatment (i.e. are overtreated).
  
  
  • 7–10 of these 25 men will develop persistent impotence and/or urinary incontinence, and some will develop persistent bowel problems, due to treatment.