Abstract
BackgroundThere is wide variation in clinical practice for the early detection of prostate cancer, not least because of the ongoing debate about the benefits of prostate-specific antigen (PSA) testing. In this study, we aimed to assess the approaches, attitudes, and knowledge of general practitioners (GPs) regarding PSA testing in primary care in the Netherlands, particularly regarding recommendations for prostate cancer.MethodsQuestionnaire surveys were sent to 179 GPs in the north-east of the Netherlands, of which 65 (36%) were completed and returned. We also surveyed 23 GPs attending a postgraduate train-the-trainer day (100%). In addition to demographic data and practice characteristics, the 31-item questionnaire covered the attitudes, clinical practice, adherence to PSA screening recommendations, and knowledge concerning the recommendations for prostate cancer early detection. Statistical analysis was limited to the descriptive level.ResultsMost GPs (95%; n = 82) stated that they had at least read the Dutch GP guideline, but just half (50%; n = 43) also stated that they knew the content. Almost half (46%; n = 39) stated they would offer detailed counseling before ordering a PSA test to an asymptomatic man requesting a test. Overall, prostate cancer screening was reported to be of minor importance compared to other types of cancer screening.ConclusionsClinical PSA testing in primary care in this region of the Netherlands seems generally to be consistent with the relevant guideline for Dutch GPs that is restrictive to PSA testing. The next step will be to further evaluate the effects of the several PSA testing strategies.
Highlights
There is wide variation in clinical practice for the early detection of prostate cancer, not least because of the ongoing debate about the benefits of prostate-specific antigen (PSA) testing
Prostate cancer screening based on PSA testing has been a matter of debate for many years, mainly because large clinical trials examining its effects on mortality have shown inconsistent results [6,7,8,9,10,11,12,13]
Study design, setting, and participants This cross-sectional pilot survey was performed in April and May 2016 by asking General practitioner (GP) in the north-east of the Netherlands to complete paper-based questionnaire
Summary
There is wide variation in clinical practice for the early detection of prostate cancer, not least because of the ongoing debate about the benefits of prostate-specific antigen (PSA) testing. A recent systematic review concluded that, at best, prostate cancer screening leads to a small reduction in diseasespecific mortality over 10 years, but that it has no effect on overall mortality [14]. This is compounded by the reality that PSA screening is not without adverse consequences, such as overdiagnosis and overtreatment, with the potential for avoidable physical harm, anxiety, and costs [14,15,16,17]. Men considering screening may receive inconsistent advice from their physicians
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