Urological cancers: do early detection strategies exist?

To determine the perceptions of healthcare professionals and the general public about the symptoms, diagnosis and available treatment of urological cancers, and thus the perceived value of screening for their early detection.

Two questionnaires were developed, based on semi-structured interviews, and distributed to 288 healthcare professionals, comprising 182 general practitioners (GPs), 56 practice nurses and 50 urology nurses, and to 250 members of the general public in three different socio-economic groups. The questionnaires asked about the symptoms, diagnosis and treatment of prostate, bladder and testicular cancer, and whether the respondents considered that screening for these cancers would be useful in ameliorating morbidity or death from these diseases.

The response rate was very poor (13 of the GPs, 7%; 34 of the nurses, 32%; and 58 members of the general public, 23%). This severely limited the interpretation of the results, but the responses highlighted areas which need addressing. Obvious symptoms were well understood by all the groups but less well-known symptoms could be missed. No GP supported screening for prostate cancer and only seven of the GPs believed in teaching testicular self-examination, but practice nurses were considerably more active in all aspects of patient education. The general public felt that they needed more information to make decisions about urological cancers, although there was a general feeling that 'screening saved lives'.

This survey showed that no healthcare professional seems to have a clearly defined role in informing potential patients about screening. The general public, who seem to perceive from the media that early detection is beneficial, are confused by the lack of clarity about policies for urological cancers.