Primary Care Physician-led Population-based Screening Program for Prostate Cancer: Bridging a Urologic Gap in Access...

Area of Science:

• Urology
• Public Health
• Primary Care Medicine

Background:

• Underserved populations face barriers to prostate cancer diagnosis.
• Prostate-specific antigen (PSA) screening is crucial for early detection.
• Primary care-led initiatives can improve access to cancer screening.

Purpose of the Study:

• To assess the feasibility and outcomes of a community-based PSA screening program.
• To improve prostate cancer diagnosis access for underserved groups.
• To evaluate guideline adherence and scalability of the screening model.

Main Methods:

• Retrospective analysis of two cohorts: Primary (n=927) and Extended (n=1,773).
• Screening adherence to 2023 AUA guidelines for men aged 45-69 (or 40-44 with risk factors).
• Triage of elevated PSA (>4 ng/mL) with repeat testing and/or multiparametric MRI (mpMRI).

Main Results:

• 89.8% guideline adherence in the primary cohort.
• Among appropriately screened men with PSA >4 ng/mL, 47% had PI-RADS 3-5 findings on mpMRI.
• 9 prostate cancers diagnosed from 12 biopsies; 48% of elevated PSA cases avoided urology referral.
• Extended cohort: 50 urology referrals and 21 definitive treatments.

Conclusions:

• Primary care-led screening effectively identifies significant prostate cancer.
• The model achieves high guideline adherence and reduces unnecessary specialist referrals.
• Integrated mpMRI triage offers a scalable strategy to address urologic care gaps and health disparities.