PSA testing of men in the haematuria clinic, a useful additional test or unnecessary investigation

Summary 

Objective

To determine prostate cancer detection rates in a haematuria clinic and provide an insight into the usefulness of PSA testing in the haematuria clinic.

Patients and methods

The records of all male patients (n=749) seen in the haematuria clinic over a 2-year period were analysed.

Results

Of the 749 men, 511 (68%) had a PSA measured. In total, 28 cases of prostate cancer were diagnosed (3.7% of total). In the 50–69 age group, 263 out of 350 men (75%) had a PSA test. 11 cancers were diagnosed in this group (which was 3.1% of all patients or 4.2% of those screened in this age group).

Conclusion

Our screening rates were slightly lower than those in the ProtecT, ERSPC and PLCO studies. Our overall cancer detection rate of 3.1% (for the 50–69 year olds) is comparable to those from ERSPC (8.2%), ProtecT (2.2%) and PLCO (1.4%). The data would suggest that there is not an excess of prostate cancer in patients with haematuria. PSA testing should be accompanied by a full and frank discussion about the benefits and risks of PSA screening which is not always practical in the haematuria clinic.

Keywords: Haematuria, Prostate cancer, PSA