Purvis Cooper Crystale, Merritt Tracie L, Ross Louie E, John Lisa V, Jorgensen Cynthia M
National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-55, Atlanta, GA 30341, USA.
Prev Med. 2004 Feb;38(2):182-91. doi: 10.1016/j.ypmed.2003.09.035.
Clinical guidelines for using the prostate-specific antigen (PSA) test as a population-based screening tool vary considerably. This study qualitatively explored primary care physicians' PSA screening practices and their understanding of the PSA screening controversy.
Fourteen telephone focus groups were conducted with 75 primary care physicians practicing in 35 US states. Data were coded around three major topics: PSA screening practices, factors influencing these practices, and familiarity with clinical guidelines.
Two practice patterns emerged. Most participants recommended regular PSA screening beginning around age 50 for asymptomatic men with no known risk factors and at least a 10-year life expectancy. These "routine screeners" attributed their approach to experience that supported the benefit of PSA screening and to patient demand for the test. Other physicians discussed the implications of PSA screening with patients before offering the test, but neither recommended for or against it. The approach of these "nonroutine screeners" was primarily guided by the lack of scientific evidence documenting the benefit of PSA screening.
The observed practice patterns reflect both sides of the PSA screening controversy. While routine and nonroutine screeners differ in their approach, both reported high rates of PSA screening.
将前列腺特异性抗原（PSA）检测用作基于人群的筛查工具的临床指南差异很大。本研究定性地探讨了初级保健医生的PSA筛查实践及其对PSA筛查争议的理解。
对在美国35个州执业的75名初级保健医生进行了14次电话焦点小组访谈。围绕三个主要主题对数据进行编码：PSA筛查实践、影响这些实践的因素以及对临床指南的熟悉程度。
出现了两种实践模式。大多数参与者建议，对于无已知风险因素且预期寿命至少还有10年的无症状男性，从50岁左右开始定期进行PSA筛查。这些“常规筛查者”将他们的做法归因于支持PSA筛查益处的经验以及患者对该检测的需求。其他医生在提供检测之前会与患者讨论PSA筛查的影响，但既不推荐也不反对。这些“非常规筛查者”的做法主要是由于缺乏记录PSA筛查益处的科学证据。
观察到的实践模式反映了PSA筛查争议的双方。虽然常规筛查者和非常规筛查者的方法不同，但两者报告的PSA筛查率都很高。
