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Screening in general practice
M R Feneley1, M G Kirby, T McNicholas
1Department of Urology, St Bartholomew's Hospital, West Smithfield, London.
Cancer Surveys
|January 1, 1995
Summary
Screening for prostate cancer in general practice is feasible, diagnosing 14 cancers in 568 men. However, a significant false positive rate exists, necessitating further large-scale studies to confirm screening benefits.
Area of Science:
- Urology
- Oncology
- General Practice
Background:
- Prostate cancer screening is a key public health concern.
- General practice settings offer a potential venue for widespread screening.
- Assessing the feasibility and yield of prostate cancer screening in primary care is crucial.
Purpose of the Study:
- To evaluate the technical feasibility and patient acceptability of prostate cancer screening in a general practice setting.
- To determine the cancer detection rate and characteristics of diagnosed cancers.
- To identify challenges and potential improvements for future screening programs.
Main Methods:
- A screening program for prostate cancer was implemented in a general practice setting.
- Participants underwent screening tests, including Prostate-Specific Antigen (PSA) testing.
- Biopsies were performed based on screening results and clinical assessment.
Main Results:
- Screening was technically feasible and generally acceptable to participants.
- 14 prostate cancers were diagnosed among 568 men screened, a detection rate of 2%.
- Five detected cancers were locally advanced or metastatic; a considerable false positive rate was observed in the PSA range of 4-10 ng/ml, especially with benign prostatic hyperplasia.
Conclusions:
- Prostate cancer screening in general practice is feasible but presents challenges.
- The detection rate needs to be weighed against the false positive rate and potential for overdiagnosis.
- A large-scale prospective controlled study is required to establish the definitive benefit of this screening approach.