New paper says GPs need guidance and skills training to facilitate decision-making

General practitioners and family doctors play an important role in counselling healthy men whether they should consider PSA testing – but they need clear guidance, training and support to assume this role.

This is the conclusion of a new paper by urologists, family doctors and patient representatives published in the journal BMC Primary Care.

The paper asks the question “Is it time to change practice in PSA testing in primary care?” pointing out that opportunistic PSA testing is currently rising with little effect on prostate cancer related deaths and late diagnosis. Patterns of testing vary among GPs and family doctors because of differing guidelines, patient pressure, time constraints and personal views.

The paper says a more effective approach would be organised, risk-adapted screening strategies using PSA testing, as outlined in the European Association of Urology’s guidelines – and endorsed in the European Commission’s cancer screening recommendations. In this scenario, GPs and family doctors would still play an important role in supporting men throughout the decision pathway, say the authors, who include Hein Van Poppel of the European Association of Urology and Europa Uomo, and Europa Uomo’s Past Chairman André Deschamps.

However, they add: “as some men may still request a PSA test from their GP or family doctor, patient information as well as clear guidance and support to GPs and family doctors are needed, including appropriate skills training to facilitate effective counselling and informed decision-making, and the use of risk calculators to inform referral decisions.”