More than 3,000 Europe Regional Medical Command patients are being notified they received the wrong prostate cancer screening test if they were examined between August 2009 and May 2012 at a military treatment facility in the region.
The U.S. Army is sending letters to 3,280 service members and Tricare beneficiaries who received a test meant as a secondary screening for prostate-specific antigens instead of the standard initial test known as the “Total PSA” test.
The Total PSA is used to detect elevated levels of PSA, the protein produced by prostate gland cells, in the bloodstream. Elevated PSA blood levels can be associated with prostate cancer.
The follow-on test, called the “Free PSA” test, is used as a secondary test to the Total PSA to help determine whether a growth is slow-growing or aggressive.
It is not recommended for initial screenings.
According to Landstuhl Regional Medical Center division medical chief Col. Thomas Frank, the mistake occurred because when the Free PSA test became available and was introduced to the command’s alphabetically organized lab order database, many physicians simply ordered the first test in the database not realizing it was not the comprehensive test.
In February 2012, laboratory staff at Landstuhl, where the tests are analyzed, noticed the increase in Free PSA requests. They corrected the database and notified physicians of the change.
In May 2013, command became aware of the situation when a patient was diagnosed with prostate cancer after receiving a series of Free PSA tests and no comprehensive test.
“When he called it to our attention, we went back and looked at the scope of the problem,” Frank said.
Frank said physicians are unaware of any other missed prostate cancer diagnoses as a result and added they are “aggressively working to let [patients] know they have not been screened for prostate cancer when we thought they had.”
Affected patients include those residing in Germany, Italy, Belgium, Kosovo and assigned to U.S. Central Command.
Frank said patients should discuss whether they need to receive a Total PSA test with their doctor. In the past several years, many physician organizations have backed off recommending routine annual screening and some patients may not need a new test.
“It should be a discussion between the patient and the physician,” Frank said.
An investigation into the matter is ongoing, he added.