Guy L, van de Steene E, Védrine N, Teissonnière M, Boiteux J-P
Service d'urologie, hôpital G. Montpied, CHU Clermont-Ferrand, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
Prog Urol. 2008 Jan;18(1):46-52. doi: 10.1016/j.purol.2007.10.006. Epub 2008 Feb 25.
To assess the practices of general practitioners in the Auvergne region concerning individual prostate cancer screening, to compare these practices with published guidelines and to identify those points that are most difficult to perform.
An anonymous postal survey using a predefined questionnaire was conducted among 1339 general practitioners in the Auvergne region identified by the URSSAF file on 1st January 2006. This was a declarative survey with no individual financial reward. The questionnaire comprised three aspects: general practitioner identification criteria, screening practices and the doctors' opinion concerning guidelines.
The participation rate was 49.1: 98.3% of general practitioners declared that they proposed screening and 89.5% declared that they proposed screening to all men within certain age limits, from 50 to 75 years in 80.8% of cases. Only 4.6% of doctors provided complete preliminary information to their patients. Among the doctors,75.6% combined digital rectal examination and total PSA assay, but in the presence of an abnormality, only 10.5% referred their patients directly to an urologist without prescribing other complementary investigations (first- or second-line). Finally, 53.5% of doctors considered that published guidelines were adapted to their clinical practice.
Individual prostate cancer screening is massively proposed, but differences are observed between the doctors' reported practices and official guidelines. This study emphasizes the need to provide patients with clear and complete information and to improve the general practitioners' knowledge on screening tests and patient referral in the case of positive screening tests.
评估奥弗涅地区全科医生开展个体前列腺癌筛查的情况，将这些做法与已发布的指南进行比较，并确定最难实施的要点。
采用预定义问卷对2006年1月1日由URSSAF文件确定的奥弗涅地区1339名全科医生进行匿名邮寄调查。这是一项无个人经济奖励的陈述性调查。问卷包括三个方面：全科医生识别标准、筛查做法以及医生对指南的看法。
参与率为49.1%：98.3%的全科医生表示他们会建议进行筛查，89.5%的医生表示他们会在特定年龄限制内（80.8%的情况为50至75岁）向所有男性建议进行筛查。只有4.6%的医生向患者提供了完整的初步信息。在医生中，75.6%的人同时进行直肠指检和总前列腺特异性抗原检测，但在发现异常时，只有10.5%的人直接将患者转诊给泌尿科医生，而没有开具其他补充检查（一线或二线检查）。最后，53.5%的医生认为已发布的指南适用于他们的临床实践。
大规模开展个体前列腺癌筛查，但医生报告的做法与官方指南之间存在差异。本研究强调需要为患者提供清晰完整的信息，并提高全科医生在筛查试验方面的知识以及在筛查试验呈阳性时患者转诊方面的知识。
