Urologists' personal feelings on PSA screening and prostate cancer treatment

This study aimed to determine if urologists' feelings on prostate cancer screening with prostate-specific antigen (PSA) and treatment on themselves are consistent with what they recommend to patients.

A survey regarding prostate cancer screening and treatment was assembled using the SurveyMonkey web site. The link to the survey was then emailed to urologists. Participation was voluntary.

The survey was sent to 2672 American urologists and completed by 215 urologists; response rate was 8%. One hundred ninety-eight (92%) were male. Most (56%) urologists recommend PSA screening beginning at age 50 for patients, and this corresponded with the age at which survey responders began their PSA screening. Two urologists did not recommend screening, and 10% were 'not sure' if screening saves lives. Of those that had not had their PSA checked, 34% plan to begin screening at 40-44 with 11% stating they 'never' plan to be screened. One hundred thirty-eight (70%) men completing the survey had their PSA checked. The majority (86%) had it drawn for screening. Nineteen respondents had an elevated PSA with nine men diagnosed with prostate cancer. Eight of these had radical prostatectomy. When faced with the hypothetical diagnosis of an elevated PSA and low-grade prostate cancer, respondents favoured repeat PSA (94%) and surveillance (48%), respectively, than any other option.

Despite recommendations from the American Urologic Association to screen men for prostate cancer, a significant percentage of urologists do not wish to be screened with PSA. Almost all, however, continue to recommend prostate cancer screening for their patients. Treatment recommendations also varied among the respondents.