[Who works in the prevention and early detection of benign prostatic hyperplasia and prostate cancer in Croatia?].

INTRODUCTION

Benign prostatic hyperplasia (BPH) is the most common benign tumor and prostate cancer is the second most common cause of cancer death in Croatia. The number of new cases of prostate cancer is expected to increase by more than half in the next 25 years. Due to limited evidence, there are different opinions about the usefulness of screening for BPH and prostate cancer.

OBJECTIVES

The aim of this study was to investigate the screening activities for BPH and prostate cancer in family practice in Croatia.

METHODS

The survey included all male patients over age of 40 (n = 614) attending two GP offices (one of them specialist in family medicine) during one year, 2003. Data on the risk factors for BPH and prostate cancer (positive family history, urinary problems), IPSS questionnaire, digitorectal examination, urine test, creatinine and prostate specific antigen blood test were collected from their medical records. chi2-test was used on statistical analysis.

RESULTS

The results of the survey showed 55 (9%) patients to be diagnosed with BPH and 22 (3.6%) with prostate cancer; 56 (9.1%) patients were asymptomsatic. Digitorectal examination was not performed at either GP office, and 481 (78.3%) patients received no information about lower urinary tract symptoms. There were no differences in screening for BPH and prostate cancer between the specialist of family medicine and physician.

CONCLUSIONS

In primary care, physicians rarely work on the prevention and early detection of BPH and prostate cancer, irrespective of their education level. There is the need of a common protocol of BHP and prostatic cancer prevention for urologists and general practitioners, since a comprehensive approach is lacking in Croatia.