Prostate cancer screening--a physician survey in Missouri

Area of Science:

• Urology
• Primary Care Medicine
• Public Health

Background:

• Prostate cancer is a significant health concern.
• Screening practices by primary care physicians (PCPs) are crucial for early detection.
• Understanding current screening trends is essential for effective public health strategies.

Purpose of the Study:

• To investigate prostate cancer screening practices among PCPs in Missouri.
• To assess the utilization of prostate specific antigen (PSA) testing, digital rectal examination (DRE), and transrectal ultrasonography (TRUS).
• To identify factors influencing PCPs' inclination towards routine screening.

Main Methods:

• A 1993 mail survey was administered to a stratified random sample of 750 PCPs in Missouri.
• The survey targeted general practice, family practice, and internal medicine specialists.
• Logistic regression analysis was used to determine predictors of screening inclination.

Main Results:

• 95% of physicians showed increased inclination towards PSA testing compared to three years prior.
• Only 45% of physicians were more inclined to use DRE.
• 85% reported increased PSA use after a negative DRE, and 90% showed increased TRUS use after a positive PSA.
• Agreement with American Cancer Society (ACS) guidelines and being in private practice predicted routine screening.

Conclusions:

• PCPs in Missouri view PSA testing favorably and are increasingly incorporating it into screening practices.
• Screening patterns align with national trends, indicating PSA's perceived utility.
• Adherence to ACS guidelines and practice setting are key determinants of routine prostate cancer screening by PCPs.