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Screening for carcinoma of the prostate: a GP based study
R S Kirby1, M G Kirby, M R Feneley
1Department of Urology, St Bartholomew's Hospital, London, UK.
British Journal of Urology
|July 1, 1994
Summary
Prostate cancer screening using digital rectal examination (DRE), prostate-specific antigen (PSA) tests, and transrectal ultrasound (TRUS) is feasible and acceptable. However, a large study is needed to confirm its true benefit due to a high false-positive rate.
Area of Science:
- Urology
- Oncology
- Preventive Medicine
Background:
- Prostate cancer is a significant health concern for aging men.
- Early detection through screening can potentially improve outcomes.
- Current screening methods require evaluation for feasibility and patient acceptance.
Purpose of the Study:
- To assess the feasibility and acceptability of a multi-modal prostate cancer screening protocol.
- To evaluate digital rectal examination (DRE), prostate-specific antigen (PSA) testing, and transrectal ultrasound (TRUS) in a general practice setting.
Main Methods:
- A health check including DRE, PSA, and TRUS was offered to men aged 55-70.
- 856 men were invited, 568 participated.
- 80 men with abnormal results underwent TRUS; 29 had biopsies, confirming 11 prostate cancers (2% prevalence).
Main Results:
- The screening detected 11 prostate cancers, with a prevalence of 2%.
- 83% of participants responded to a questionnaire; 69% reported no concern.
- 69% of those undergoing TRUS reported discomfort, but 95% would repeat the screening.
Conclusions:
- Prostate cancer screening via DRE, PSA, and TRUS is technically feasible and generally acceptable to patients.
- A significant false-positive rate exists for PSA levels between 4-10 ng/ml, especially with benign prostatic hyperplasia.
- Further large-scale, prospective, controlled studies are essential to determine the true benefit of this screening approach.