Prostate cancer screening practices amongst physicians in the North Simcoe Muskoka Local Health Integration Network

The prostate-specific antigen (PSA) screening test is controversial and can result in both over-diagnosis and over-treatment. Recently, the Canadian Task Force on Preventive Health Care (CTFPHC) has recommended against routine screening for prostate cancer. We sought to determine how the CTFPHC has impacted the practice patterns among family physicians in the North Simcoe Muskoka (NSM) Local Health Integration Network (LHIN).

We surveyed all 439 family physicians within the NSM LHIN as well as 21 residents of the Family Medical Teaching Unit. Surveys were distributed by either mail or fax. Questions covered three sections: 1) demographics, 2) screening practice, and 3) perceptions of screening efficacy.

The overall survey response rate was 33.3%. In all, 39.5% of physicians felt that prostate cancer screening did not provide a survival benefit, and 13.1% did not offer PSA screening. These beliefs were more likely to be held by younger physicians (age < 45), and those with < 10 years of practice (p < 0.05). Interestingly, female physicians were less likely to believe that PSA screening provided a survival benefit (p ≤ 0.01); however, no gender bias for PSA screening practices was observed (p = 0.73). Of the physicians who agreed with CTFPHC's recommendation (31.8%), 6.0% do not offer PSA screening because of the recommendation. The CTFPHC recommendation had no impact on the age at which physicians begin or stop offering PSA screening (p > 0.05).

Despite the CTFPHC recommendations, prostate cancer screening remains controversial. Practice patterns amongst general practitioners in the NSM LHIN vary considerably, but seem to have been minimally impacted.