General practitioner perception of prostate-specific antigen testing has improved, but more awareness of prostate cancer risk in younger patients is still awaited.
| cam.issuedOnline | 2017-10-14 | |
| dc.contributor.author | Thurtle, David R | |
| dc.contributor.author | Gordon, Emma M | |
| dc.contributor.author | Brierly, Robert D | |
| dc.contributor.author | Conway, Ciaran J | |
| dc.contributor.author | McLoughlin, John | |
| dc.contributor.orcid | Thurtle, David [0000-0001-5636-7088] | |
| dc.date.accessioned | 2018-11-08T00:30:20Z | |
| dc.date.available | 2018-11-08T00:30:20Z | |
| dc.date.issued | 2018-06 | |
| dc.description.abstract | BACKGROUND: 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.medium | Print-Electronic | |
| dc.identifier.doi | 10.17863/CAM.32102 | |
| dc.identifier.eissn | 2287-903X | |
| dc.identifier.issn | 2287-8882 | |
| dc.identifier.uri | https://www.repository.cam.ac.uk/handle/1810/284730 | |
| dc.language | eng | |
| dc.language.iso | eng | |
| dc.publisher | Elsevier BV | |
| dc.publisher.url | http://dx.doi.org/10.1016/j.prnil.2017.10.001 | |
| dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | |
| dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | |
| dc.subject | Early diagnosis | |
| dc.subject | General practice | |
| dc.subject | Prostate cancer | |
| dc.subject | Prostate specific antigen | |
| dc.title | General practitioner perception of prostate-specific antigen testing has improved, but more awareness of prostate cancer risk in younger patients is still awaited. | |
| dc.type | Article | |
| dcterms.dateAccepted | 2017-10-08 | |
| prism.endingPage | 65 | |
| prism.issueIdentifier | 2 | |
| prism.publicationDate | 2018 | |
| prism.publicationName | Prostate Int | |
| prism.startingPage | 61 | |
| prism.volume | 6 | |
| rioxxterms.licenseref.startdate | 2018-06 | |
| rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
| rioxxterms.type | Journal Article/Review | |
| rioxxterms.version | VoR | |
| rioxxterms.versionofrecord | 10.1016/j.prnil.2017.10.001 |
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