Burrows Thomas, Ray A Andrew, Hartsburg Cory
Barrie Urology Group, Barrie, Ontario, Canada.
Can J Urol. 2017 Apr;24(2):8734-8739.
The prostate-specific antigen (PSA) screening test is controversial and can result in both over-diagnosis and over-treatment. Recently, the Canadian Task Force on Preventive Health Care (CTFPHC) has recommended against routine screening for prostate cancer. We sought to determine how the CTFPHC has impacted the practice patterns among family physicians in the North Simcoe Muskoka (NSM) Local Health Integration Network (LHIN).
We surveyed all 439 family physicians within the NSM LHIN as well as 21 residents of the Family Medical Teaching Unit. Surveys were distributed by either mail or fax. Questions covered three sections: 1) demographics, 2) screening practice, and 3) perceptions of screening efficacy.
The overall survey response rate was 33.3%. In all, 39.5% of physicians felt that prostate cancer screening did not provide a survival benefit, and 13.1% did not offer PSA screening. These beliefs were more likely to be held by younger physicians (age < 45), and those with < 10 years of practice (p < 0.05). Interestingly, female physicians were less likely to believe that PSA screening provided a survival benefit (p ≤ 0.01); however, no gender bias for PSA screening practices was observed (p = 0.73). Of the physicians who agreed with CTFPHC's recommendation (31.8%), 6.0% do not offer PSA screening because of the recommendation. The CTFPHC recommendation had no impact on the age at which physicians begin or stop offering PSA screening (p > 0.05).
Despite the CTFPHC recommendations, prostate cancer screening remains controversial. Practice patterns amongst general practitioners in the NSM LHIN vary considerably, but seem to have been minimally impacted.
前列腺特异性抗原（PSA）筛查试验存在争议，可能导致过度诊断和过度治疗。最近，加拿大预防性医疗保健特别工作组（CTFPHC）建议不要对前列腺癌进行常规筛查。我们试图确定CTFPHC对北锡姆科·马斯科卡（NSM）地方卫生整合网络（LHIN）家庭医生的执业模式产生了怎样的影响。
我们对NSM LHIN内的所有439名家庭医生以及家庭医学教学单元的21名住院医师进行了调查。调查问卷通过邮寄或传真方式分发。问题涵盖三个部分：1）人口统计学，2）筛查实践，3）对筛查效果的看法。
总体调查回复率为33.3%。总的来说，39.5%的医生认为前列腺癌筛查没有带来生存益处，13.1%的医生不提供PSA筛查。年轻医生（年龄<45岁）以及执业年限<10年的医生更有可能持有这些观点（p<0.05）。有趣的是，女医生不太可能认为PSA筛查能带来生存益处（p≤0.01）；然而，在PSA筛查实践中未观察到性别偏见（p = 0.73）。在同意CTFPHC建议的医生中（31.8%），6.0%的医生由于该建议而不提供PSA筛查。CTFPHC的建议对医生开始或停止提供PSA筛查的年龄没有影响（p>0.05）。
尽管有CTFPHC的建议，但前列腺癌筛查仍然存在争议。NSM LHIN地区全科医生的执业模式差异很大，但似乎受到的影响最小。
