Isala clinics, Department of Urology, Zwolle, The Netherlands.
BMC Fam Pract. 2012 Oct 11;13:100. doi: 10.1186/1471-2296-13-100.
Prostate specific antigen (PSA) testing is widely used, but guidelines on follow-up are unclear.
We performed a systematic review of the literature to determine follow-up policy after PSA testing by general practitioners (GPs) and non-urologic hospitalists, the use of a cut-off value for this policy, the reasons for repeating a PSA test after an initial normal result, the existence of a general cut-off value below which a PSA result is considered normal, and the time frame for repeating a test. Data sources. MEDLINE, Embase, PsychInfo and the Cochrane library from January 1950 until May 2011. Study eligibility criteria. Studies describing follow-up policy by GPs or non-urologic hospitalists after a primary PSA test, excluding urologists and patients with prostate cancer. Studies written in Dutch, English, French, German, Italian or Spanish were included. Excluded were studies describing follow-up policy by urologists and follow-up of patients with prostate cancer. The quality of each study was structurally assessed.
Fifteen articles met the inclusion criteria. Three studies were of high quality. Follow-up differed greatly both after a normal and an abnormal PSA test result. Only one study described the reasons for not performing follow-up after an abnormal PSA result.
Based on the available literature, we cannot adequately assess physicians' follow-up policy after a primary PSA test. Follow-up after a normal or raised PSA test by GPs and non-urologic hospitalists seems to a large extent not in accordance with the guidelines.
前列腺特异性抗原（PSA）检测被广泛应用，但针对该检测的后续随访方案并不明确。
我们对文献进行了系统性回顾，以确定初级 PSA 检测后全科医生和非泌尿科医院医师的随访政策、用于制定该政策的 PSA 截断值、初次正常结果后重复 PSA 检测的原因、是否存在普遍的截断值使得 PSA 结果被认为正常，以及重复检测的时间框架。数据来源：1950 年 1 月至 2011 年 5 月间 MEDLINE、Embase、PsychInfo 和 Cochrane 图书馆。研究入选标准：描述初级 PSA 检测后全科医生或非泌尿科医院医师随访政策的研究，不包括泌尿科医生和前列腺癌患者。研究语言为荷兰语、英语、法语、德语、意大利语或西班牙语。排除描述泌尿科医生随访政策和前列腺癌患者随访的研究。对每篇研究的质量进行了结构性评估。
符合纳入标准的研究共有 15 篇。其中 3 篇研究质量较高。正常和异常 PSA 检测结果后的随访差异很大。仅有一篇研究描述了异常 PSA 结果后未进行随访的原因。
基于现有文献，我们无法充分评估医生在初次 PSA 检测后的随访政策。初级 PSA 检测后，全科医生和非泌尿科医院医师的正常或升高 PSA 检测随访在很大程度上不符合指南。
