Authors: Nathan Lawrentschuk Nikhil Daljeet Clement Ma Karen Hersey Alexandre Zlotta Neil Fleshner
Publish Date: 2010/06/12
Volume: 43, Issue: 1, Pages: 31-37
Abstract
Recent data have suggested historical cutoff levels for prostate cancer PC screening using a prostatespecific antigen PSA level ≤ 4 ng/ml may no longer be appropriate with cancer detected at lower levels particularly in younger men Our aim was to conduct a contemporary survey of urologist’s practice patterns toward PC detection specifically focusing on factors determining the decision to recommend ultrasoundguided biopsy TRUSBXOf 360 urologists 125 35 completed the questionnaire Sixtyseven percent indicated men should be screened for PC aged 50–60 with 27 preferring 40–50 years Seventyseven percent would continue screening 75 Considering a 65yearold man with no risk factors and a normal digital rectal exam 56 would offer TRUSBX at PSA 45 35 at 35 and 10 at 25 ng/ml Considering a similar 45yearold man 94 would at PSA 45 77 at 35 and 33 at 25 ng/ml On multivariate analysis offering TRUSBX appears driven significantly P 00001 more by younger age and higher PSA OR 43–206 and 44–349 respectively rather than family history or ethnicity OR 33 and 18 respectivelyAge and PSA appear the driving factors in obtaining TRUSBX Also a significant proportion of urologists would still not offer TRUSBX at the traditional PSA cutoff of 4 ng/ml for men with no risk factors Further studies are required to ascertain whether this relates to a lack of dissemination of studies into practice
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