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Prostate-specific antigen testing in general practice: a survey among 325 general practitioners in Denmark
Morten Jønler1, Ben Eddy, Johan Poulsen
1Department of Urology, Aalborg Hospital, Aalborg, Denmark. jonler@dadlnet.dk
Scandinavian Journal of Urology and Nephrology
|August 25, 2005
Summary
General practitioners (GPs) show inconsistent use of prostate-specific antigen (PSA) testing for prostate cancer screening. Further education is needed to standardize PSA testing and improve early prostate cancer diagnosis.
Area of Science:
- Urology
- Oncology
- General Practice
Background:
- Prostate-specific antigen (PSA) is a key tumor marker for prostate cancer, but elevated levels can stem from benign conditions.
- General Practitioners (GPs) are crucial in the initial diagnosis and referral pathway for suspected prostate diseases.
- Standardized knowledge of PSA testing interpretation is vital for effective patient management.
Purpose of the Study:
- To evaluate the current practices and knowledge of PSA testing among GPs.
- To identify the need for further education on PSA testing within the GP community.
- To assess the impact of PSA testing on the early diagnosis of prostate cancer.
Main Methods:
- A questionnaire survey was distributed to all GPs in the Northern County of Denmark.
- Non-respondents were followed up via mail to maximize response rates.
- The survey focused on PSA testing habits and perceived educational needs.
Main Results:
- A high response rate (90%) was achieved among the surveyed GPs.
- Inconsistent PSA testing practices were observed: only 28% tested all males with lower urinary tract symptoms (LUTS), and 10% during general health checks.
- Referral decisions were influenced by PSA levels (79%), age (65%), and digital rectal examination (DRE) findings (87%), with a median referral PSA of 5 ng/ml.
Conclusions:
- PSA testing is not standardized among GPs in the study area, deviating from established national/international guidelines.
- PSA testing is underutilized in men with LUTS, and referral criteria may delay early prostate cancer detection.
- While DRE, age, and PSA value influence referral decisions, enhanced GP education on PSA testing is recommended to improve diagnostic accuracy and patient outcomes.