Australian General Practitioners' Understanding of PSA Testing Guidelines: A Survey‐Based Study

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ABSTRACT PSA screening remains controversial, but evolving evidence and updated Australian guidelines now support informed testing decisions. Given GPs' key role in PSA screening, this study examines NSW GPs' understanding, attitudes and practices to identify gaps in applying current national recommendations. General practitioners (GP) in New South Wales were identified through Primary Health Networks (PHNs), and private hospital research networks and invited to participate in an online survey between August 2022 and August 2023. A total of 81 final questionnaires were completed and included in the final analysis. All GPs were based in New South Wales, Australia. In total, 15 of the respondents were regional (18.5%). In total, 73 were consultant GPs (90.2%), 7 were GP registrars (8.6%) and 1 was an international medical graduate (1.2%). In total, 69.1% (56) of GPs used the GP Red Book as their primary source of guidance for PSA testing, while only 21% utilised the most current National Health and Medical Research Council and Prostate Cancer Foundation of Australia (NHMRC/PCFA) guidelines. Most GPs (80.2%) also used the lab‐reported age‐adjusted cutoff rather than the PCFA suggested 3.0 ng/mL (14.8%). GPs also rarely offered PSA as a screening test to men with only 14.8% offering it to all men, and 43.2% offering PSA testing after men enquire about it based on general knowledge. GPs in New South Wales may still be reluctant to offer PSA testing to patients and are unclear about what PSA values require further investigation based on the heterogenous responses to the survey. The RACGP Red Book guidelines have been influential in informing GP understanding about when to offer PSA testing and should be brought more in line with the Prostate Cancer Foundation of Australia Guidelines, and further improvement could be made to the reporting of PSA reference ranges to better guide interpretation of a positive PSA result.

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