PROSTATE-SPECIFIC ANTIGEN TESTING IN AUSTRALIA AND ASSOCIATION WITH PROSTATE-CANCER INCIDENCE IN NEW-SOUTH-WALES

Objective: To describe patterns and trends in prostate-specific antige n (PSA) testing in Australia and assess its role in the increasing inc idence of prostate cancer. Design: Descriptive analysis of (i) Medicar e records of PSA testing in Australia, and (ii) prostate cancer record ed incidence in New South Wales. Data: (i) Medicare data for all males who received a Medicare-reimbursed PSA test between August 1989 and D ecember 1996. (ii) NSW Central Cancer Registry data for all males in N SW with prostate cancer diagnosed between 1988 and 1995. Main outcome measures: (i) Number of PSA tests, age-standardised rates of PSA tests by State and Territory and proportions of males who had a PSA test. ( ii) Recorded incidence of prostate cancer in NSW. Results: (i) More th an 2.2 million PSA tests were done on more than 1.1 million Australian s between 1989 and 1996. The annual number of males tested increased f ivefold in this period and peaked in 1995. Twenty-seven per cent of Au stralian men aged 50 years or over had at least one PSA test in 1995 o r 1996; 33% of men aged 60-69 years had a test in this period. (ii) in NSW the number of PSA tests per quarter was highly correlated with th e number of new cases of prostate cancer (R-2=0.92). Conclusions: Alth ough no organised program for prostate cancer screening exists, and de spite repeated advice against it, opportunistic screening has been occ urring at high rates. There was a high correlation between PSA testing and prostate cancer incidence between 1990 and 1995 in NSW.