Prostate specific antigen testing policy worldwide varies greatly and seems not to be in accordance with guidelines: A systematic review

Van der Meer, S., Löwik, S., Hirdes, W. H., Nijman, R. M., Van der Meer, K., Hoekstra-Weebers, J. E. H. M. & Blanker, M. H., 11-Oct-2012, In : BMC Family Practice. 13, 9 p., 100.

Research output: Contribution to journalReview articleAcademicpeer-review

Background: Prostate specific antigen (PSA) testing is widely used, but guidelines on follow-up are unclear.

Methods: We performed a systematic review of the literature to determine follow-up policy after PSA testing by general practitioners (GPs) and non-urologic hospitalists, the use of a cut-off value for this policy, the reasons for repeating a PSA test after an initial normal result, the existence of a general cut-off value below which a PSA result is considered normal, and the time frame for repeating a test. Data sources. MEDLINE, Embase, PsychInfo and the Cochrane library from January 1950 until May 2011. Study eligibility criteria. Studies describing follow-up policy by GPs or non-urologic hospitalists after a primary PSA test, excluding urologists and patients with prostate cancer. Studies written in Dutch, English, French, German, Italian or Spanish were included. Excluded were studies describing follow-up policy by urologists and follow-up of patients with prostate cancer. The quality of each study was structurally assessed.

Results: Fifteen articles met the inclusion criteria. Three studies were of high quality. Follow-up differed greatly both after a normal and an abnormal PSA test result. Only one study described the reasons for not performing follow-up after an abnormal PSA result.

Conclusions: Based on the available literature, we cannot adequately assess physicians' follow-up policy after a primary PSA test. Follow-up after a normal or raised PSA test by GPs and non-urologic hospitalists seems to a large extent not in accordance with the guidelines.

Original languageEnglish
Article number100
Number of pages9
JournalBMC Family Practice
Publication statusPublished - 11-Oct-2012


  • Prostate specific antigen, PSA, Follow-up, General practitioners, Non-urologic hospitalists, Guidelines, Systematic review, PRIMARY-CARE PRACTITIONERS, GENERAL-PRACTICE, EAU GUIDELINES, CANCER, METAANALYSIS, DYSFUNCTION, PREVALENCE, PHYSICIANS, MORTALITY, MEN

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