%0 Journal Article
%T Danish General Practitioners' Use of Prostate-Specific Antigen in Opportunistic Screening for Prostate Cancer: A Survey Comprising 174 GPs
%A Kasper Jessen
%A Jens S£¿ndergaard
%A Pia Veldt Larsen
%A Janus Laust Thomsen
%J International Journal of Family Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/540707
%X Background. The use of prostate-specific antigen test has markedly increased in Danish general practice in the last decade. Despite the national guidelines advice against PSA screening, opportunistic screening is supposed to be the primary reason for this increased number of PSA tests performed. Aims. Based on the increase in the amount of PSA conducted, we aimed to analyse how GPs in Denmark use the PSA test. Methods. A self-administrated questionnaire concerning symptomatic and asymptomatic patient cases was developed based on the national and international guidelines and the extensive literature review, and an in-depth interview conducted with a GP was performed. Results. None of the GPs would do a PSA measurement for an asymptomatic 76-year-old man. For asymptomatic 55- and 42-year-old men, respectively, 21.9% and 18.6% of GPs would measure PSA. Patient request and concern could be potential reasons for measuring PSA for asymptomatic patients. Almost all GPs stated that a PSA measurement is indicated for symptomatic 49- and 78-year-old men, respectively, 98.9% and 93.8%. Conclusion. Opportunistic PC screening is being performed in general practice to a high degree. Hence, current guidelines are not followed, and intense focus should be on more effective implementation strategies in order to avoid overuse of PSA. 1. Introduction Prostate cancer (PC) in Denmark (DK) and many other western countries is the most prevalent cancer in men. In 2010, it caused 1210 deaths in Danish men, corresponding to a mortality rate of 20.4 per 100.000 men [1]. With 4060 new cases in 2010, it is still the most common cancer among men, with an incident rate of 142 per 100.000 [2]. Prostate-specific antigen (PSA) testing used as opportunistic screening could be a reason for the increase in incidence [3, 4]. In the Aarhus county in Denmark, the number of PSA measurements performed has increased 43-fold in the period from 1995 to 2006 [4]. Noteworthy, out of the total 86,077 included PSA samples, the proportion performed in general practice increased from 38.6% in 1998 to 66.1% in 2006 [4]. Two recent randomised controlled trials (RTC) found that PSA screening does not influence overall prostate cancer mortality. The European trial ERSPC found after a median follow up of 9 and 11 years a similar PC mortality rate ratio (RR) among men aged from 55 to 69, respectively, 0.80 and 0.79 [5, 6]. It is noteworthy to mention that only 2 of the 7 included centers in the ERSPC trial found a statistically significant reduction in PC mortality after 11 years and seemed to contribute to
%U http://www.hindawi.com/journals/ijfm/2013/540707/