Andreassen Lisbet A, Vondeling Hindrik
Syddansk Universitet Odense, Det Sundhedsvidenskabelige Fakultet, Den Sundhedsfaglige Kandidatuddannelse og Suppleringsuddannelsen.
Ugeskr Laeger. 2006 Jan 30;168(5):475-7.
The incidence of prostate cancer is increasing. Potentially curative treatment can be attempted in clinically localised disease, emphasising the role of early diagnosis. Prostate-specific antigen (PSA) is used as a biological marker for prostate cancer, but its value as a diagnostic test is associated with some degree of uncertainty. In 1999 the Danish Uro-Oncological Committee recommended measurement of the ratio of free to total PSA (f/tPSA) as a complementary analysis to total PSA (tPSA) in patients in whom the tPSA level is below 10 ng/mL. To assess whether the recommendation of the Danish Uro-Oncological Committee has been implemented in daily clinical practice, we carried out a survey of a pre-selected sample of hospital laboratories.
Fifteen laboratories in Denmark, all associated with a university hospital, were surveyed in April 2004. Questions focused on current laboratory practice with regard to tPSA and f/t PSA.
Within or outside their own facilities, the hospital laboratories all had tPSA analysed, and 64 percent had f/t PSA analysed. All the laboratories used the same critical value for tPSA (<4 ng/mL), while there was considerable variation in the critical value applied for f/tPSA. Forty-four percent of laboratories partially complied with the recommendation of the Danish Uro-Oncological Committee to analyse f/t PSA in addition to tPSA in patients in whom the total PSA level is below 10 ng/mL.
Despite the recommendation of the Danish Uro-Oncological Committee, measurement of f/tPSA is not fully implemented in laboratories associated with university hospitals in Denmark. There is considerable practice variation in the analysis of f/t PSA as well.
