Evidence map›Paper›PMID 41062172›Full record

ArticleBMJ (Clinical research ed.)2025

Prostate specific antigen retesting intervals and trends in England: population based cohort study.

Kiana K Collins, Jason L Oke, Pradeep S Virdee, Rafael Perera, Brian D Nicholson

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PubMed Full text at PMC Publisher
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Article in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kiana K CollinsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK kiana.collins@phc.ox.ac.uk.ORCID 0000-0002-3736-6976
Jason L OkeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
Pradeep S VirdeeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
Rafael PereraNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
Brian D NicholsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo characterise the use of the prostate specific antigen (PSA) test in primary care in England.

designPopulation based open cohort study.

settingEngland.

participants10 235 805 male patients older than 18 years and registered at 1442 general practices that contributed to the Clinical Practice Research Datalink between 2000 and 2018. Data were linked to the National Cancer Registry, Hospital Episode Statistics, and Office for National Statistics.

main outcome measuresPopulation based temporal trends and annual percentage changes were analysed using age standardised PSA testing rates. Mixed effects negative binomial regression models investigated individual patient rate ratios of PSA testing. Linear mixed effects models examined factors associated with an individual patient's length of PSA retesting intervals. All results were analysed by region, deprivation, age, ethnicity, family history of prostate cancer, symptom presentation, and PSA value.

results1 521 116 patients had at least one PSA test, resulting in 3 835 440 PSA tests overall. 48.4% (735 750) of these patients had multiple tests and 72.8% (535 990) of them never presented with a PSA value above the age specific referral threshold. The median retesting interval overall was 12.6 months (interquartile range 6.2-27.5). Testing rates varied by region, deprivation, ethnicity, family history, age, PSA value, and symptoms. Once tested, patients had shorter retesting intervals if they were older, were of an ethnicity other than white, had a family history of prostate cancer, or had previously raised PSA levels. Despite considerable variation in testing rates by region and deprivation, the length of retesting intervals was similar across these groups.

conclusionsPSA testing before a diagnosis of prostate cancer in primary care in England varied. Among patients who underwent multiple tests, many were tested more frequently than recommended, raising concerns about overtesting. PSA retesting is occurring in patients without recorded symptoms and in those with low PSA values. To ensure maximum benefit to patients while reducing the risk of overtesting, research is urgently needed to determine appropriate evidence based PSA retesting intervals.

Indexed as

Early Detection of CancerProstate-Specific AntigenProstatic NeoplasmsAdultAgedAged, 80 and overCohort StudiesEnglandHumansMaleMiddle AgedPrimary Health CareTime FactorsProstate-Specific Antigen

Identifiers

PMID41062172
PMCPMC12505835

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.