Measurement of serum levels of Prostate Specific Antigen (PSA) is used as a test for detecting prostate cancer and can be used as a screening test. Population screening has been shown to reduce deaths from prostate cancer, but screening also leads to the detection of slow growing cancers that would never have caused any problem or symptoms in a mans life time, resulting in overtreatment and side effects. Because of these concerns there is currently no screening programme for prostate cancer in England; however, under the Prostate Cancer Risk Management Programme, men aged 50 or over can request a PSA test from their General Practitioner (GP) after they have been informed about the potential harms and benefits.
We aim to study the effectiveness of the current National Health Service (NHS) policy for PSA testing by comparing the PSA testing history of patients who died from prostate cancer to that of men who did not die from the disease.
We aim to compare the PSA testing history of patients who died from prostate cancer to that of matched controls in England.
Cases will be men with records in the Clinical Practice Research Datalink (CPRD) primary care database who died from prostate cancer at age 55-84 in 2003-2017. Cases will be identified from CPRDs linked ONS death data.
Controls will be matched to cases on age and a range of criteria, depending on the analysis set to which they belong.
Both cases and controls will have been registered with a CPRD GOLD GP practice for at least 2 years before case diagnosis this is the period during which exposure to PSA testing will be measured. By reviewing the CPRD records, we will identify all PSA tests in this period and classify them into those likely to have been carried out for screening purposes and those carried out for other reasons. We will seek GP practice-level data on PSA testing practices and investigate the role of self-selection.
Conditional logistic regression analysis, adjusted for ethnicity, deprivation and GP practice, will be used to estimate the odds ratio of dying of prostate cancer for screened vs. non-screened men.
Primary: death from prostate cancer
Peter Sasieni - Chief Investigator - King's College London (KCL)
Shama Sheikh - Corresponding Applicant - King's College London (KCL)
Alejandra Castanon - Collaborator - King's College London (KCL)
Chris Mathews - Collaborator - King's College London (KCL)
Louise Johns - Collaborator - King's College London (KCL)
Matejka Rebolj - Collaborator - King's College London (KCL)
NCRAS Cancer Registration Data;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation