Determinants of prostate-specific antigen test use in prostate cancer screening by primary care physicians

Austin, Orson; Valente, Stephanie A.; Hasse, Lora; Kues, John R.

doi:10.1001/archfami.6.5.453

Cited by 36 publications

(31 citation statements)

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“…Variables included demographic descriptors,14,16,18–21 specialty orientation,14,18–20 family experience with disease,20 class year, 21 and knowledge of prostate cancer screening, epidemiology, and treatment 10,12…”

Section: Methodsmentioning

confidence: 99%

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A National Survey of Medical Students’ Beliefs and Knowledge in Screening for Prostate Cancer

Marcella

Delnevo²,

Coughlin³

2007

J GEN INTERN MED

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Section: Methodsmentioning

confidence: 99%

“…Students responded to a list of 8 true/false statements previously employed by Austin and colleagues 12. There is no “unsure” choice in this instrument.…”

Section: Methodsmentioning

confidence: 99%

A National Survey of Medical Students’ Beliefs and Knowledge in Screening for Prostate Cancer

Marcella

Delnevo²,

Coughlin³

2007

J GEN INTERN MED

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“…The incidence rate returned to or near the 1988 baseline in the following years. However, some American physicians still hesitate to apply PSA testing for mass screening, since its effectiveness in decreasing the mortality and morbidity of prostate cancer remains to be proved (55,56). On the other hand, mass or individual screening by serum PSA assay is not recommended by the Oncology Committee of the French Association of Urology (57).…”

Section: Screeningmentioning

confidence: 99%

Prostate-Specific Antigen and New Related Markers for Prostate Cancer

Daher¹,

Beaini²

1998

CCLM

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Although prostate-specific antigen (PSA), or human kallikrein 3, is the most valuable tool available for the diagnosis and management of prostate cancer, as currently used it is insufficiently sensitive and specific for early detection or staging of the malignancy. Many new concepts have been introduced in order to optimize the clinical use of PSA measurements, but each one has its own drawbacks. The molecular forms of PSA, especially the free PSA, seem to be useful for the detection of prostate cancer in men with PSA concentrations falling in the 4-10 microg/l range. New molecular techniques, such as reverse transcriptase polymerase chain reaction for the detection of minimal amounts of PSA messenger RNA and prostate-specific membrane antigen, offer new promise for the prognosis and possibly staging of prostate cancer. On the other hand, human kallikrein 2, a serine protease closely related to PSA that is also expressed predominantly in the prostate, may be a new adjuvant marker for prostate cancer. As for its biological functions, PSA can no longer be regarded as a specific prostate molecule associated mainly with semen liquefaction when it has a possible role as a prognostic indicator in female breast cancer. The biological role of PSA in normal tissues and tumors may be much more complex than previously thought and requires further investigation.

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“…6,7 Because of the ambiguity of this recommendation, there is significant variation in screening practice across multiple factors that are not clinically relevant, such as geographic location, remuneration mechanism, and personal opinion. [7][8][9][10][11] Ultimately, any realized benefit of PSA screening, as well as potential harm, will rest on the decision to perform a transrectal ultrasound and biopsy (TRUS-BX). However, uncertainty about PSA result interpretation leads to uncertainty about when to biopsy.…”

Section: Introductionmentioning

confidence: 99%

Variations in prostate biopsy practice: A quantitative questionnaire-based study

Lipinski

Groome

2013

CUAJ

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original research E732Cite as: Can Urol Assoc J 2013;7(11-12):e732-9. http://dx.doi.org/10.5489/cuaj.372 Published online November 8, 2013. AbstractBackground: The ambivalent results of recent large randomized prostate cancer studies have added a significant layer of uncertainty for clinicians and patients contemplating investigation of early disease. This uncertainty and lack of prescriptive recommendations from professional organizations has led to significant variation in practice in North America. The purpose of this study was to determine the extent of variation in biopsy recommendations by urologists and to discern factors predictive for these recommendations. Methods: An anonymous, cross-sectional, self-report questionnaire was sent to all active members of the Canadian Urological Association practicing in Ontario. The survey consisted of demographic data and 10 closed-ended questions designed to capture biopsy preferences in ambiguous clinical situations. Respondent preferences for recommending a prostate biopsy were compared to a guideline-informed study standard. Descriptive and correlative statistics were used to analyze the responses. Results: The response rate to the survey was 74%. The responses showed considerable variability in recommendations for or against biopsy. While most of the urologists concurred with the research team's study standard recommendations, only 4 scenarios had over 80% concurrence and 1 scenario, which centered on the utility of free PSA, had only had 42% concurrence. None of the respondent's descriptors were associated with trends to recommend biopsy other than the number of biopsies performed per year (p = 0.04). Interpretation: This self-report survey investigating prostate biopsy thresholds identifies considerable variation in practicing urologists in Ontario. The drivers of biopsy recommendations in these relatively ambiguous clinical situations appeared to be age, suspicious rectal examinations, and total PSA.

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Determinants of prostate-specific antigen test use in prostate cancer screening by primary care physicians

Cited by 36 publications

References 0 publications

A National Survey of Medical Students’ Beliefs and Knowledge in Screening for Prostate Cancer

A National Survey of Medical Students’ Beliefs and Knowledge in Screening for Prostate Cancer

Prostate-Specific Antigen and New Related Markers for Prostate Cancer

Variations in prostate biopsy practice: A quantitative questionnaire-based study

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