Gjengstø Peder, Eide Johan, Frugård Jannicke, Bakke August, Høisaeter Per Age
Section of Urology, Department of Surgery, The Gade Institute, Haukeland University Hospital, Bergen, Norway.
Scand J Urol Nephrol. 2004;38(1):15-8. doi: 10.1080/00365590310019990.
Potentially curable prostate cancer is a diagnostic challenge for the general practitioner (GP). In a defined catchment area we wanted to discover why patients consulted their GPs and the reasons for their referral to the urologist.
Patients remitted to our "early prostate cancer clinic" with suspected potentially curable prostate cancer between January 1997 and December 2000 were included in the study. Patient information was registered according to a prospectively designed protocol.
Of the 872 patients examined, prostate cancer was diagnosed in 41.3% (360/872). Median age was 63.1 years and median total prostate-specific antigen (PSA) level was 8.6 microg/l. The main reason for referral to a urologist was elevated PSA alone. However, the majority of the patients had no urological symptoms when they consulted their GP. As no local or national screening recommendations existed, we believe that opportunistic PSA screening has been common.
The most important reason for referring patients to our specialist clinic was elevated PSA, often detected by means of opportunistic PSA screening. This study shows the effect of PSA testing in real-life practice.
对于全科医生(GP)而言,潜在可治愈的前列腺癌是一项诊断挑战。在一个特定的集水区,我们想探究患者咨询全科医生的原因以及他们被转诊至泌尿科医生处的原因。
纳入1997年1月至2000年12月间被转诊至我们“早期前列腺癌诊所”、疑似患有潜在可治愈前列腺癌的患者。患者信息根据前瞻性设计的方案进行记录。
在872名接受检查的患者中,41.3%(360/872)被诊断患有前列腺癌。中位年龄为63.1岁,总前列腺特异性抗原(PSA)水平的中位数为8.6微克/升。转诊至泌尿科医生处的主要原因仅是PSA升高。然而,大多数患者在咨询全科医生时并无泌尿系统症状。由于当时没有地方或国家的筛查建议,我们认为机会性PSA筛查很常见。
将患者转诊至我们专科诊所的最重要原因是PSA升高,这通常是通过机会性PSA筛查检测出来的。本研究显示了PSA检测在实际临床实践中的作用。