Abstract
BACKGROUND: There is inconclusive evidence that prostate cancer screening with prostate-specific antigen (PSA) reduces mortality. Although PSA testing is widespread, it is unknown how many physicians have taken the PSA test themselves.
OBJECTIVE: To determine the prevalence of PSA testing among physicians.
DESIGN: Cross-section survey.
SUBJECTS: A nationwide stratified random sample of urologists (response rate 61%, n=247), Internists (response rate 51%, n=273), and family physicians (response rate 64%, n=249) were surveyed by mail in 2000. After excluding female respondents and men who either reported a positive history of prostate cancer or did not respond to that query, there were 146 urologists, 96 Internists, and 118 family physicians.
MEASUREMENTS: Whether physicians had undergone prostate cancer screening with PSA.
RESULTS: Eighty-seven percent (155/178) of male physicians aged, 50 and older and 21% (31/150) of white male physicians under age 50 reported having had a PSA test. More urologists than nonurologists in both age groups reported having had a screening PSA test.
CONCLUSION: Most physicians aged 50 and older report undergoing PSA testing. This may reflect a belief in its efficacy and contribute to its widespread use.
References
Coley CM, Barry MJ, Fleming C, Mulley AG. Early detection of prostate cancer, Part I: prior probability and effectiveness of tests. The American College of Physicians. Ann Intern Med. 1997;126:394–406.
Woolf SH. Screening for prostate cancer with prostate-specific antigen: an examination of the evidence. N Engl J Med. 1995;333:1401–5.
Stamey TA, Caldwell M, McNeal JE, Nolley R, Hemenez M, Downs J. The prostate specific antigen era in the United States is over for prostate cancer: what happened in the last 20 years? J Urol. 2004;172:1297–301.
Gohagan JK, Prorok PC, Kramer BS, Cornett JE. Prostate cancer screening in the prostate, lung, eolorectal, and ovarian cancer screening trial of the National Cancer Institute. J Urol. 1994;152:1905–9.
Schroder FH, Kranse R, Rietbergen J, Hoedemaeke R, Kirkels W. The European Randomized Study of Screening for Prostate Cancer. (ERSPC): an update. Members of the ERSPC, Section Rotterdam. Eur Urol. 1999;35:539–43.
American College of Physicians. Screening for prostate cancer. Ann Intern Med. 1997;126:480–4.
American Cancer Society. Summary of American Cancer Society recommendations for the early detection of cancer in asymptomatic people. In: Cancer Facts and Figures 2001. Atlanta, GA: National Home Office, American Cancer Society Inc.; 2001:35.
American Academy of Family Physicians. Introduction to AAFP summary of policy recommendations for periodic health examination. Available at: http://www.aafp.org/policy/camp/apndx_fc.html. Accessed July 10, 2001.
American Urological Association. Prostate-specific antigen (PSA) best practice policy. Oncology. 2001;14:267–72; 277–80.
U.S. Preventive Services Task Force. Screening for prostate cancer: recommendation and rationale. Ann Intern Med. 2002;137:915–6.
Moran WP, Cohen SJ, Preisser JS, Wofford JL, Shelton BJ, McClatchey MW. Factors influencing use of the prostate-specific antigen screening test in primary care. Am J Manag Care. 2000;6:315–24.
McKnight JT, Tietze PH, Adcock BB, Maxwell AJ, Smith WO, Nagy MC. Screening for prostate cancer: a comparison of urologists and primary care physicians. South Med J. 1996;89:885–8.
Fowler FJ Jr., Bin L, Collins MM, et al. Prostate cancer screening and beliefs about treatment efficacy: a national survey of primary care physicians and urologists. Am J Med. 1998;104:526–32.
Sirovich BE, Schwartz LM, Woloshin S. Screening men for prostate and colorectal cancer in the United States. Does practice reflect the evidence? JAMA. 2003;289:1414–20.
Voss JD, Schnectman JM. Prostate cancer screening practices and beliefs. A longitudinal physician survey. J Gen Intern Med. 2001;16:831–7.
Ross LE, Coates RJ, Breen N, Uhler RJ, Potosky AL, Blackman D. Prostate-specific antigen test use reported in the 2000 National Health Interview Survey. Prev Med. 2004;38:732–44.
Livingston P, Cohen P, Frydenberg M, et al. Knowledge, attitudes and experience associated with testing for prostate cancer: a comparison between male doctors and men in the community. Intern Med J. 2002;32:215–23.
Chan ECY, Vernon SW, Haynes MC, O’Donnell FT, Ahn C. Physician perspectives on the importance of facts men ought to know about prostate-specific antigen testing. J Gen Intern Med. 2003;18:350–6.
Kalish LA, McDougal WS, McKinlay JB. Family history and the risk of prostate cancer. Urology. 2000;56:803–6.
Cantor SB, Volk RJ, Cass AR, Gilani J, Spann SJ. Psychological benefits of prostate cancer screening: the role of reassurance. Health Expectations. 2002;5:104–13.
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The authors have no conflicts of interest to report.
This study was funded by National Cancer Institute grant K08-CA78615, awarded to Dr. Chan as a clinical scientist award. Additional support was provided by Centers for Disease Control/Association of Schools of Public Health, grant #S1171-19/20, and NIH grant M01-RR02558, the Clinical Research Center at the University of Texas-Houston.
Contributions of Authors: Dr. Chan and Dr. Barry participated in the conceptualization of the study, and with Dr. Vernon and Dr. Ahn designed the study and analyzed the data. All authors had access to all data in the study and held final responsibility for the decision to submit this work for publication. All authors approved of the final version.
Conflict of Interest Statement for Authors: The authors declare that they had no financial or personal conflicts of interest that could have inappropriately biased this study. Dr. Chan had full access to all data in the study and had final responsibility for the decision to submit this manuscript for publication.
Ethics Approval: The authors obtained institutional board review approval from the Committee for the Protection of Human Subjects at the University of Texas-Houston Health Sciences Center, Houston, TX, U.S.A., to conduct the study.
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Chan, E.C.Y., Barry, M.J., Vernon, S.W. et al. Brief report: Physicians and their personal prostate cancer-screening practices with prostate-specific antigen. J Gen Intern Med 21, 257–259 (2006). https://doi.org/10.1111/j.1525-1497.2006.00327.x
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DOI: https://doi.org/10.1111/j.1525-1497.2006.00327.x