GPs views and understanding of PSA testing, screening and early detection; survey

Abstract

Background: There is currently no national prostate cancer screening programme in the UK. However, patients 50 years and older are entitled to a prostate specific antigen (PSA) test, if informed on the advantages and disadvantages of testing and their risk of cancer. The Prostate Cancer Risk Management Programme (PCRMP) provides this guidance. Aim: The aim of this study was to access GPs' views and understanding of PSA testing, prostate cancer screening and early detection. Method: A total of 708 questionnaires were returned by GPs across two English regions in 2013 and the GP questionnaire responses were quantitatively analysed. Results: In the 699 completed questionnaires, the majority of GPs were well informed about PSA testing, screening and early detection. Only 32% used guidelines for referral, 14% knew all age-specific PSA referral levels, 71% that Black men have a higher prostate cancer risk than White men (22% correctly answered threefold increase) and 82% that family history is a risk factor. A further 78% thought electronic prompts during consultation would encourage PCRMP guideline usage and 75% had never been offered a PSA test and prostate cancer educational course, of which 73% would like to attend a course. Only 23% were aware of the latest PSA screening evidence (1) and 94% would like an update. Conclusions: Participating GPs seem to be well informed but need more information and tools to help follow recommended guidance. In particular, increased awareness of PCRMP guidelines especially by automated methods, further educational courses and evidence updates would be beneficial. What's known• To our knowledge, there are no similar large published surveys on GPs views and understanding of PSA testing, screening and early detection within England and the PCRMP guidelines.

<p>Early detection of prostate cancer using prostate-specific antigen testing: an empirical evaluation among general practitioners and urologists</p>

“…All urologists indicated to know the S3 guideline in detail and 94.9% stated to consider the guideline in their daily practice, while the answers of some questions were not in consistence with the guideline. This is in accordance with other studies stating that although doctors have favorable attitudes toward guidelines on PCa, guideline knowledge is limited 30,31. One study stated that physicians handling after a normal or raised PSA seems to a large extent not in accordance with guidelines on PCa screening which agrees with our results 32…”

“…Accordingly, there seems to be an urgent need to educate and support doctors more (GPs, as well as urologists and doctors with other specialties dealing with PSA testing) concerning PSA testing 19,27,30. This is important for further improving the quality of the urological health care.…”

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“…This is best done by DAs, which can increase the knowledge and awareness about testing and empower men to make a decision. 46 Moreover, as not all physicians who are consulted by men for a PSA test are sufficiently informed on their own, 58 , 59 , 60 and a great proportion of physicians seem not to apply guidelines correspondingly, 33 , 50 DAs may thus improve the counselling provided by physicians. 23 , 61 …”

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