Knowledge and Attitudes of Primary Care Physicians Regarding Prostate Cancer Screening

Pendleton, John; Curry, R Whit; Kaserian, A.l.i.; Chang, Myron; Anai, Satoshi; Nakamura, Kogenta; Abdoush, Phillip; Rosser, Charles J.

doi:10.1016/s0027-9684(15)31339-0

Cited by 12 publications

(19 citation statements)

References 14 publications

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“…Lim and Quinlan [18] also reported poor performance rates, with 17% of patients having both a DRE and PSA testing. This is in contrast to Pendleton et al, [10] who found that 79% of patients had both PSA and DRE findings. McNaughton et al [17] indica ted that nearly all (97%) of the respondents agreed that performing both the PSA test and a DRE is more effective in assessing the presence of prostate cancer.…”

Section: Discussioncontrasting

confidence: 83%

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A finger or not? Prostate examinations by non-urologists at a South African academic institution

Spencer¹

2017

S Afr Med J

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Background. According to the South African (SA) National Cancer Registry 2009, prostate cancer is the most commonly diagnosed solidorgan cancer in SA men: the incidence increases at ~3% every year, with 1/26 men developing prostate cancer in their lifetime and five men dying every day. Screening for prostate cancer by performing a digital rectal examination (DRE) adds to the sensitivity and specificity of serum prostate-specific antigen (PSA) testing and is an important component of the assessment for the early detection of prostate cancer. Objectives. To ascertain whether doctors who are not in the field of urology perform DREs and PSA testing to screen for prostate cancer, where indicated, and to determine the reason, if any, why doctors do not perform prostate examinations. Methods. Doctors (including specialists and primary care practitioners) who consulted adult male patients in the emergency departments and polyclinics of three academic hospitals were included in the sample and asked to complete an anonymous questionnaire. Doctors with specialist urological training were excluded from the sample. The questionnaire included the following aspects: gender, year of graduation and university, current position, knowledge of PSA screening and DRE, whether these were being performed, and reasons for nonperformance. Results. The response rate was 303/350 participants. Fifty-nine percent of the respondents were female. The median duration of experience was 5 years. The mean (standard deviation) knowledge score with regard to screening was 56.1% (20). The PSA test alone was most frequently done (35%), followed by asking the patient about urinary tract symptoms (28%). In contrast, DRE of the prostate, alone or combined with a PSA test, was performed less frequently (13.2% and 10.6%, respectively). Some of the most common reasons for not performing a DRE included: 'It's more convenient to do a PSA test'; 'Urologists will examine the prostate anyway'; 'No privacy in the emergency department/admission ward'; 'Prostate exam is not relevant to my practice'; 'There is not enough time'; and 'The practitioner forgets' . Doctors with >7 years of working experience are the least likely to do a DRE. Conclusion. Performance rates of DRE and PSA testing by doctors who are not urologists are very low, which may have significant clinical implications. It is recommended that SA prostate cancer screening guidelines are necessary to change practice with regard to this condition.

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Section: Discussioncontrasting

confidence: 83%

“…[10][11][12] It was modified to the SA context by adding more reasons for non-performance of the DRE, such as no lubrication jelly and no space to examine the patient in the admission ward. The questionnaire was then piloted on a small cohort of doctors to check for validity of the modifications.…”

Section: Data Collection Process/toolmentioning

confidence: 99%

A finger or not? Prostate examinations by non-urologists at a South African academic institution

Spencer¹

2017

S Afr Med J

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“…Applying the inclusion and exclusion criteria, 929 were excluded on the basis of the title and abstract (Kappa: 0.90) and 160 on the basis of the full text (Kappa: 0.95). Twenty articles were retained: 14 studies analysing the PCP's point of view [24][25][26][27][28][29][30][31][32][33][34][35][36][37] , 5 studies analysing the patient's point of view [38][39][40][41][42] , one study analysing both. 43 3.1.…”

Section: Resultsmentioning

confidence: 99%

“…In the U.S., more than 60% of PCP's were considered as "aggressive" screeners for prostate cancer 26,35 , with 61% to 88% of PCPs recommending PSA screening to healthy patients. 26,31,33,34,37 Physicians reported high and rising rates of PSA testing from 1993 to 1998. 34 The number of PCPs recommending PSA testing of healthy men is also high in Canada (87.5% 28 last year.…”

Section: Pcps' Self-reported Practicesmentioning

confidence: 99%

The decision-making process in prostate cancer screening in primary care with a prostate-specific antigen: A systematic review

Vedel

Puts

Monette

et al. 2011

Journal of Geriatric Oncology

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“…15 Factors that have been cited as barriers to physician-patient discussions of prostate cancer screening include lack of time and the complexity of the topic, 14 patient comorbidity, 11 and perception by physicians that the health literacy of their patients is too low for such discussions to be of value. 9 Although some researchers have asked physicians and/or their patients whether they discussed prostate cancer screening, 10,16 the nature of such discussions has not been assessed.…”

Section: Introductionmentioning

confidence: 99%

Discussions About Prostate Cancer Screening Between U.S. Primary Care Physicians and Their Patients

et al. 2011

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OBJECTIVE: This study examined the likelihood that U.S. primary care physicians (PCPs) discuss and recommend prostate cancer screening with their patients and physician-related and practice-related factors associated with this behavior. METHODS: We analyzed data from the 2007-2008 National Survey of Primary Care Physician Practices Regarding Prostate Cancer Screening (N=1,256), the most recent and comprehensive survey specifically designed to address issues concerning prostate cancer screening and representing nearly 95,000 PCPs. We evaluated the relationship between PCP behavior regarding prostate cancer screening discussions and covariates, including PCP demographic and practicerelated factors. Weighted percentages and Chi-square tests were used to compare use of screening discussions by PCP characteristics. Adjusted odds of discussing screening and recommending the PSA test were determined from logistic regression. RESULTS: Eighty percent of PCPs reported that they routinely discuss prostate cancer screening with all of their male patients, and 64.1% of PCPs who discussed screening with any patients reported that they attempted to talk their patients into getting the PSA test. In multivariate analyses, encouraging PSA testing was more likely among non-Hispanic black PCPs (OR= 2.80, 95% CI [1.88, 4.16

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Knowledge and Attitudes of Primary Care Physicians Regarding Prostate Cancer Screening

Cited by 12 publications

References 14 publications

A finger or not? Prostate examinations by non-urologists at a South African academic institution

A finger or not? Prostate examinations by non-urologists at a South African academic institution

The decision-making process in prostate cancer screening in primary care with a prostate-specific antigen: A systematic review

Discussions About Prostate Cancer Screening Between U.S. Primary Care Physicians and Their Patients

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