Prostate cancer screening. What family physicians believe is best
R. J. Hicks, R. M. Hamm and D. A. Bemben
Department of Family Medicine, Oklahoma University Health Sciences Center, Oklahoma City, USA.
OBJECTIVE: To determine current family physician beliefs concerning
prostate cancer screening. DESIGN: Two hundred eighty-six Oklahoma family
physicians were surveyed by mail. Fifty-three percent of physicians
returned the questionnaire. Physicians were questioned on what tests they
order for prostate screening, the reasons for ordering a serum
prostate-specific antigen (PSA) test, what test results would cause a
urologic referral for further evaluation of prostate cancer, and whether
prostate cancer screening would decrease the patient's mortality or improve
quality of life. RESULTS: Most physicians (74%) believed that both a
digital rectal examination and a serum PSA determination are appropriate
for prostate cancer screening. Physicians' primary reasons for ordering a
PSA test were to decrease patient mortality and morbidity. Sixty-two
percent of physicians believed that prostate cancer screening would
decrease mortality and 69% agreed that screening would improve quality of
life. Approximately 90% of physicians would refer patients with a PSA level
greater than 12 micrograms/L or a PSA level of 5 micrograms/L and an
indurated prostate. Significant variation was found between groups of
physicians in their beliefs about prostate cancer screening. CONCLUSION:
Although the literature has been inconclusive on the benefit of prostate
cancer screening, the majority of Oklahoma family physicians would choose
to screen their patients and believe that patients' mortality and morbidity
are decreased by early identification of prostate cancer.
