Prostate cancer screening. What family physicians believe is best

To determine current family physician beliefs concerning prostate cancer screening.

Two hundred eighty-six Oklahoma family physicians were surveyed by mail. Fifty-three percent of physicians returned the questionnaire. Physicians were questioned on what tests they order for prostate screening, the reasons for ordering a serum prostate-specific antigen (PSA) test, what test results would cause a urologic referral for further evaluation of prostate cancer, and whether prostate cancer screening would decrease the patient's mortality or improve quality of life.

Most physicians (74%) believed that both a digital rectal examination and a serum PSA determination are appropriate for prostate cancer screening. Physicians' primary reasons for ordering a PSA test were to decrease patient mortality and morbidity. Sixty-two percent of physicians believed that prostate cancer screening would decrease mortality and 69% agreed that screening would improve quality of life. Approximately 90% of physicians would refer patients with a PSA level greater than 12 micrograms/L or a PSA level of 5 micrograms/L and an indurated prostate. Significant variation was found between groups of physicians in their beliefs about prostate cancer screening.

Although the literature has been inconclusive on the benefit of prostate cancer screening, the majority of Oklahoma family physicians would choose to screen their patients and believe that patients' mortality and morbidity are decreased by early identification of prostate cancer.