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dc.contributor.authorThurtle, David R
dc.contributor.authorGordon, Emma M
dc.contributor.authorBrierly, Robert D
dc.contributor.authorConway, Ciaran J
dc.contributor.authorMcLoughlin, John
dc.date.accessioned2018-11-08T00:30:20Z
dc.date.available2018-11-08T00:30:20Z
dc.date.issued2018-06
dc.identifier.issn2287-8882
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/284730
dc.description.abstractBACKGROUND: In 2006, a county-wide survey of general practitioners (GPs) in the United Kingdom (UK) identified a reluctance to refer younger men with abnormal prostate specific antigen (PSA) levels. Younger men have the most to gain from early-detection of prostate cancer (PCa), which remains a national government priority in the UK and around the world. We sought to assess changes in perception of abnormal PSA-values amongst UK GPs over the past 10 years. MATERIALS AND METHODS: A total of 500 self-administered paper questionnaires were distributed to individually named GPs. One hundred and forty two responded (28.4%), representing a patient population of ∼600,000. A series of visual analogue questions assessed referral thresholds and understanding of risk factors related to the development of PCa. RESULTS: GPs with a median of 23-years experience responded. Although mean PSA threshold for referral to urology did fall between 2006 and 2016 in both the 45-year (5.42 ng/mL vs. 4.61 ng/mL P = 0.0003) and 55-year (5.81 ng/mL vs. 5.30 ng/mL P = 0.0164) age groups, the median referral values were unchanged. Significantly, referral thresholds quoted for younger men (<65 years) were considerably higher than recommended UK maximum PSA-levels. Using case-based scenarios, practitioners appeared more likely to refer older men with abnormal PSA values, with GPs reporting an average 56.2% likelihood of referring an asymptomatic 55-year-old with elevated age-adjusted PSA of 4.6 ng/mL. A total of 95.1% recognised a family history of PCa to be a potential risk factor but other at-risk categories were not so clearly understood. CONCLUSION: Awareness of abnormal PSA values in UK primary care is improving, but continues to lag behind the evidence. Strategies to disseminate knowledge of maximum PSA-values to GPs should focus especially on those for younger patients.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherElsevier BV
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.titleGeneral practitioner perception of prostate-specific antigen testing has improved, but more awareness of prostate cancer risk in younger patients is still awaited.
dc.typeArticle
prism.endingPage65
prism.issueIdentifier2
prism.publicationDate2018
prism.publicationNameProstate Int
prism.startingPage61
prism.volume6
dc.identifier.doi10.17863/CAM.32102
dcterms.dateAccepted2017-10-08
rioxxterms.versionofrecord10.1016/j.prnil.2017.10.001
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-06
dc.contributor.orcidThurtle, David [0000-0001-5636-7088]
dc.identifier.eissn2287-903X
rioxxterms.typeJournal Article/Review
cam.issuedOnline2017-10-14


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Attribution-NonCommercial-NoDerivatives 4.0 International
Except where otherwise noted, this item's licence is described as Attribution-NonCommercial-NoDerivatives 4.0 International