Introduction: The 2006 Endocrine Society testosterone therapy in adult men guidelines were audited against the clinical practice at a UK teaching hospital endocrine department. The aim of the audit was to determine whether patients were undergoing appropriate screening tests for prostate cancer and polycythaemia as described in these guidelines.
Method: Patients were initially identified by searching the endocrine clinic letter database for the names of all testosterone replacement preparations. Patients were randomised and the following data was collected: indication for testosterone use; date testosterone replacement commenced; baseline and post treatment measurements of PSA, digital rectal examination & haematocrit.
Results: The initial search revealed a possible 499 patients that could be receiving testosterone replacement therapy. We audited 180 patients selected at random. 159 of the 180 patients were receiving testosterone replacement therapy at the time of the audit. Of these 14% of patients were commenced on testosterone therapy within the previous twelve months. The most common indication for commencing therapy was due to pituitary pathology (59%). PSA was measured in 48% of patients receiving testosterone therapy within a one year period. Digital rectal examination was never performed or recorded in any patient receiving testosterone replacement therapy. Haematocrit was measured in 47% of patients receiving testosterone therapy within a one year period.
Conclusion: This audit highlights the difference between clinical practice and the 2006 Endocrine Societies guidance. It is important that local practice is regularly audited either against national or local guidelines to ensure high standards. We were not surprised to discover digital rectal examinations were not regularly undertaken, but expected a higher rate of PSA testing. In the poster we also discuss recent US, European and Japanese recommendations on screening for prostate cancer.
30 Apr - 04 May 2011
European Society of Endocrinology