THE USEFULNESS OF PROSTATE SPECIFIC ANTIGEN SCREENING IN MALE PATIENTS PRESENTED WITH HAEMATURIA
Background:In our study, we wanted to assess if prostate specific antigen (PSA) test is a useful test for patients presenting to our urgent clinics with Haematuria, or if it can be safely omitted, unless there were any clinical indication or after discussion with patients according to NICE guidelines.
Objective:Our objective is to review if the PSA test is a useful test that should be done routinely for all male patients presented to urgent clinic with haematuria in our practice in District hospital in UK.
Methods: We looked at retrospective data for 200 patients who presented with visible haematuria (VH) and non-visible haematuria (NVH) between 50-79 years old, between January 2016 and June 2017.All patients underwent digital rectal examination (DRE) and PSA testing as part of our standard investigation for haematuria.
Results:Out of 200 cases, 155 with visible haematuria, 10 of them underwent further investigations and two were diagnosed with prostate cancer and 45 with non-visible haematuria, 4 of them had further tests and none were diagnosed as prostate cancer. Overall number of patients who underwent further investigations is 14/200 (7%).Overall rate of prostate cancer diagnosis was 1%. The rate of diagnosis with visible haematuria 1.29%, and 0% with non-visible haematuria.
Conclusion:Despite using PSA as standard investigation for patients who are presented to urgent clinic with Haematuria, the rate of cancer diagnosis is very low (1%) and detected in patients with abnormal DRE, rather than elevated PSA. Our cancer detection rate 1% is less than those from ERSPC (8.2%), ProtecT (2.2%) and PLCO (1.4%). PSA should not be considered as a useful test of standard investigations for haematuria, unless abnormal DRE was found during examination.