Pilot study of screening for prostate cancer in general practice

Area of Science:

• Urology
• Oncology
• Public Health

Background:

• Cancer screening program success relies on test sensitivity and population participation.
• Digital rectal screening and prostate-specific antigen (PSA) measurement are potential screening tools for prostate cancer.

Purpose of the Study:

• To evaluate the effectiveness of digital rectal screening and PSA measurement in a prostate cancer screening program.
• To identify optimal patient recruitment strategies for screening programs.

Main Methods:

• 814 men aged 55-70 were recruited via five methods.
• Men with suspicious prostates or PSA > 4 ng/ml were referred for further investigation (ultrasonography, biopsy).
• Screening participation rates and diagnostic yields were analyzed.

Main Results:

• 58% (472 men) participated in screening.
• PSA measurement was superior to digital rectal examination; all 7 prostate cancer cases had elevated PSA, but only 1 had a palpable abnormality.
• 7 men were diagnosed with localized prostate cancer, with 5 undergoing radical prostatectomy.

Conclusions:

• Prostate-specific antigen (PSA) testing demonstrates higher sensitivity than digital rectal examination for prostate cancer detection.
• Direct appointment scheduling and flagging patient records are effective recruitment strategies for cancer screening programs.