Jessen Kasper, Søndergaard Jens, Larsen Pia Veldt, Thomsen Janus Laust
Research Unit for General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000 Odense C, Denmark.
Int J Family Med. 2013;2013:540707. doi: 10.1155/2013/540707. Epub 2013 Nov 19.
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.
背景。在过去十年中,丹麦全科医疗中前列腺特异性抗原检测的使用显著增加。尽管国家指南建议不要进行前列腺特异性抗原筛查,但机会性筛查被认为是进行此类检测数量增加的主要原因。目的。基于前列腺特异性抗原检测量的增加,我们旨在分析丹麦的全科医生如何使用该检测。方法。根据国家和国际指南以及广泛的文献综述,编制了一份关于有症状和无症状患者病例的自填式问卷,并对一名全科医生进行了深入访谈。结果。没有一位全科医生会对一名76岁无症状男性进行前列腺特异性抗原检测。对于55岁和42岁无症状男性,分别有21.9%和18.6%的全科医生会检测前列腺特异性抗原。患者的要求和担忧可能是对无症状患者进行前列腺特异性抗原检测的潜在原因。几乎所有全科医生都表示,对于有症状的49岁和78岁男性,分别有98.9%和93.8%的情况表明应进行前列腺特异性抗原检测。结论。在全科医疗中,机会性前列腺癌筛查的程度很高。因此,目前的指南未得到遵循,应高度关注更有效的实施策略,以避免前列腺特异性抗原的过度使用。