scholarly journals Factors Related to Prostate-Specific Antigen–Based Prostate Cancer Screening in Primary Care: Retrospective Cohort Study of 120,587 French Men Over the Age of 50 Years

10.2196/10352 ◽  
2018 ◽  
Vol 4 (4) ◽  
pp. e10352 ◽  
Author(s):  
Cédric Rat ◽  
Heloise Schmeltz ◽  
Sylvain Rocher ◽  
France Nanin ◽  
Aurélie Gaultier ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Primary Care ◽  
Cohort Study ◽  
Cancer Screening ◽  
Prostate Specific Antigen ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Prostate Cancer Screening ◽  
Specific Antigen

scholarly journals Prostate-specific antigen testing and opportunistic prostate cancer screening in England (1998-2017): a cohort study

2020 ◽  
pp. bjgp20X713957
Author(s):  
Ashley Kieran Clift ◽  
Carol Coupland ◽  
Julia Hippisley-Cox
Keyword(s):  
Prostate Cancer ◽  
Cohort Study ◽  
Cancer Screening ◽  
Prostate Specific Antigen ◽  
Prostate Cancer Screening ◽  
Randomised Trial ◽  
Specific Antigen ◽  
Opportunistic Screening ◽  
Psa Screening ◽  
Psa Testing

Abstract Background: Prostate cancer is a leading cause of cancer-related death. Interpretation of results from trials of screening with prostate-specific antigen (PSA) are complex in terms of defining optimal prostate cancer screening policy. Aims: Assess the rates of, and factors associated with the uptake of PSA testing and opportunistic screening (PSA test in absence of symptoms) in England between 1998 and 2017. Estimate the likely rates of pre-randomisation screening and contamination (unscheduled screening in ‘control’ arm) of the UK-based Cluster Randomised Trial of PSA Testing for Prostate Cancer (“CAP”). Design and Setting: Open cohort study of men aged 40-75 years at cohort entry (1998-2017) undertaken using the QResearch database. Method: Eligible men were followed for up to 19-years. Rates of PSA testing and opportunistic PSA screening were calculated and Cox regression was used to estimate associations. Results: The cohort comprised 2,808,477 men, of whom 631,426 had a total of 1,720,855 PSA tests. We identified that 410,751 men had opportunistic PSA screening. Cumulative proportions of uptake of opportunistic screening in the cohort: 10% at 5yrs, 23% at 10yrs, and 44% at 19yrs of follow-up. The potential rate of contamination in the CAP control arm was estimated at 24.5%. Conclusions: A substantial number of men in England opt-in to opportunistic prostate cancer screening despite uncertainty regarding the efficacy and harms. The rate of opportunistic prostate cancer screening in the population is likely to have contaminated the CAP trial making it difficult to interpret the results.

scholarly journals Prostate-specific antigen testing for prostate cancer screening: A national survey of Canadian primary care physicians’ opinions and practices

2017 ◽  
Vol 11 (12) ◽  
pp. 396-403 ◽  
Author(s):  
Mitchell Geoffrey Goldenberg ◽  
Sean C. Skeldon ◽  
Madhur Nayan ◽  
Yegappan Suppiah ◽  
Linda Chow ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Prostate Specific Antigen ◽  
National Survey ◽  
Primary Care Physicians ◽  
Task Force ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Psa Screening

Introduction: In 2014, the Canadian Task Force on Preventive Health Care (CTFPHC) recommended against routine prostate cancer screening with the prostate-specific antigen (PSA) blood test.1 We surveyed Canadian primary care physicians (PCPs) to understand their opinions and attitudes towards prostate cancer screening in 2016.Methods: Twenty PCPs piloted the survey to assess its accessibility. We distributed a flyer to 19 633 PCPs as an insert in a large mailed package inviting them to attend a national meeting, and later promoted the survey at the meeting. Multinomial logistic regression models examined factors associated with agreement of key guideline statements and the overall benefit of PSA screening.Results: A total of 1254 PCPs responded (rate of 6.4%); 54.7% of physicians aware of the CTFPHC recommendations report screening less often as a result. Overall, 55.6% of PCPs feel that the risks of PSA screening outweigh the benefits. On multivariable analysis, physicians who did not read the guidelines, did not have an academic appointment, or were in practice for over 20 years were significantly more likely to disagree with the statement that men 55‒69 years old should not be screened for prostate cancer with PSA.Conclusions: Our national survey found that the prostate cancer screening practices of Canadian PCPs varies widely across physician demographic groups, with almost equal numbers for or against. This has significant ethical, medical, and legal implications. The poor response rate to highly incentivized survey request may suggest a reluctance or general apathy towards this subject because of the Task Force recommendations. Future efforts should provide physicians with objective guidance around PSA screening, incorporating input from all stakeholders, including PCPs, urologists, and patients.

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