THE USEFULNESS OF PROSTATE SPECIFIC ANTIGEN SCREENING IN MALE PATIENTS PRESENTED WITH HAEMATURIA

  • AHMED ABDELHAFEZ Urology Department, East Lancashire Hospitals NHS Trust, Lancashire, United Kingdom.
  • KHALED HOSNY Urology Department, East Lancashire Hospitals NHS Trust, Lancashire, United Kingdom.
  • THOMAS THOMPSON Urology Department, East Lancashire Hospitals NHS Trust, Lancashire, United Kingdom.
  • OMAR W. S. AL-MULA ABED Urology Department, East Lancashire Hospitals NHS Trust, Lancashire, United Kingdom
Keywords: Haematuria, PSA test, Prostate cancer

Abstract

https://doi.org/10.31386/dmj.2019.12.1.1

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.

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References

1.King, K. and Steggall, M. Haematuria: from identification to treatment. British Journal of Nursing. 2014; 23 (Sup9), pp.S28-S32.
2. Rodgers M, Nixon J, Hempel S,Aho T, Kelly J, Neal D, et al. Diagnostic tests and algorithms used in the investigation of haematuria: systematic reviews and economic evaluation. Health Technol Assess. 2006;10(18):iii–iv. xi–259.
3. Schroder F.H.,Hugosson J, Roobol MJ, Tammela TL, Zappa M, Nelen V et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014; 384: 2027
4. Grubb RL 3rd, Pinsky PF, Greenlee RT,Izmirlian G, Miller AB, Hickey TP et al. Prostate cancer screening in the Prostate, Lung, Colorectal and Ovarian cancer screening trial: update on findings from the initial four rounds of screening in a randomized trial.BJU Int. 2008 Dec;102(11):152430.
5. Andriole GL, Crawford ED, Grubb RL 3rd, Buys SS, Chia D, Church TR,et al. Prostate Cancer Screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial:mortality results after 13 years of follow up. J Natl Cancer Inst. 2012 Jan, 18; 104(2)
6. Donovan J, Hamdy F, Neal D, Peters T, Oliver S, Brindle L, et al. Prostate testing for cancer and treatment (ProtecT) feasibility study. Health Technol Assess 2003;7(14):1—88.
7. Suspected Cancer: Recognition and Referral | Guidance and Guidelines | NICE." Nice.org.uk. N.p., 2018. Web. 14 Sept. 2018.
8. Prostate cancer risk management programme (PCRMP): benefits and risks of PSA testing.[online]. Available at: https://www.gov.uk/government/publi cations/prostate-cancer-riskmanagement-programme-psa-testbenefits-and-risks/prostate-cancerrisk-management-programme-pcrmpbenefits-and-risks-of-psa-testing#fn:2 [Accessed 18 Sep. 2018]
9. Louie KS. UKNSC Screening for Prostate Cancer Review -2015 update. UK National Screening Committee, 2016. 10. O'Connor OJ, Fitzgerald E, Maher MM. Imaging of hematuria. American Journal of Roentgenology. 2010;195(4):W263–W267.
11. O’Connor OJ, McSweeney SE, Maher MM. Imaging of Hematuria. Radiologic Clinics of North America. 2008;46(1):113–132.
12. Roobol, M., Kranse, R., van der Cruijsen, I. and Schröder, F. A more advanced clinical stage is positively correlated with an increased prostate cancer detection rate. Urology.2002; 59(1), pp.91-96.
13. Catalona, W., Richie, J., Ahmann, F., Hudson, M., Scardino, P., Flanigan, R., et al. Comparison of Digital Rectal Examination and Serum Prostate Specific Antigen in the Early Detection of Prostate Cancer: Results of a Multicenter Clinical Trial of 6,630 Men. The Journal of Urology.1994; 151(5), pp.1283-1290.
14. Khadra M, Pickard R, Charlton M, Powell P, Neal D. A prospective analysis of 1,930 patients with hematuria to evaluate current diagnostic practice. J Urol 2000;163(2):524-7.
15. Bromage SJ, Napier-Hemy RD, Payne RD, Pearce I, McIntyre IG. The use of prostate-specific antigen testing in men presenting with haematuria. BJU Int. 2006 Dec;98(6):1221-4.
16. Chandrasekharan S, Shafik AA , and Eaton JD. PSA Testing of Men in the Haematuria Clinic, a Useful Additional Test or Unnecessary Investigation.Journal of Clinical Urology. 2010; Vol 3, Issue 1, pp. 11 - 14.
17. Prostate cancer risk management programme (PCRMP): benefits and risks of PSA testing. [online] Available at: https://www.gov.uk/government/publi cations/prostate-cancer-risk-managem ent-programme-psa-test-benefits-andrisks/prostate-cancer-risk-management -programme-pcrmp-benefits-and-risks -of-psa-testing[Accessed11Dec.2019]. 18. EAU Guidelines. Edn. presented at the EAU Annual Congress Copenhagen 2018. ISBN 978-94-92671-01-1.
Published
2019-12-15
How to Cite
ABDELHAFEZ, A., HOSNY, K., THOMPSON, T., & W. S. AL-MULA ABED, O. (2019). THE USEFULNESS OF PROSTATE SPECIFIC ANTIGEN SCREENING IN MALE PATIENTS PRESENTED WITH HAEMATURIA. Duhok Medical Journal, 13(2), 1-8. Retrieved from http://www.dmj.uod.ac/index.php/dmj/article/view/86