Division of Epidemiology and Biometry, Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
BMC Fam Pract. 2020 Dec 17;21(1):270. doi: 10.1186/s12875-020-01350-3.
There is wide variation in clinical practice for the early detection of prostate cancer, not least because of the ongoing debate about the benefits of prostate-specific antigen (PSA) testing. In this study, we aimed to assess the approaches, attitudes, and knowledge of general practitioners (GPs) regarding PSA testing in primary care in the Netherlands, particularly regarding recommendations for prostate cancer.
Questionnaire surveys were sent to 179 GPs in the north-east of the Netherlands, of which 65 (36%) were completed and returned. We also surveyed 23 GPs attending a postgraduate train-the-trainer day (100%). In addition to demographic data and practice characteristics, the 31-item questionnaire covered the attitudes, clinical practice, adherence to PSA screening recommendations, and knowledge concerning the recommendations for prostate cancer early detection. Statistical analysis was limited to the descriptive level.
Most GPs (95%; n = 82) stated that they had at least read the Dutch GP guideline, but just half (50%; n = 43) also stated that they knew the content. Almost half (46%; n = 39) stated they would offer detailed counseling before ordering a PSA test to an asymptomatic man requesting a test. Overall, prostate cancer screening was reported to be of minor importance compared to other types of cancer screening.
Clinical PSA testing in primary care in this region of the Netherlands seems generally to be consistent with the relevant guideline for Dutch GPs that is restrictive to PSA testing. The next step will be to further evaluate the effects of the several PSA testing strategies.
前列腺癌的早期检测在临床实践中有很大的差异，这主要是因为关于前列腺特异性抗原（PSA）检测的益处仍存在争议。在这项研究中，我们旨在评估荷兰初级保健中全科医生（GP）在 PSA 检测方面的方法、态度和知识，特别是关于前列腺癌的建议。
我们向北荷兰省东北部的 179 名全科医生发送了问卷调查，其中 65 名（36%）完成并返回。我们还调查了参加研究生培训日的 23 名全科医生（100%）。除了人口统计学数据和实践特征外，31 项问卷涵盖了态度、临床实践、对 PSA 筛查建议的依从性以及对前列腺癌早期检测建议的知识。统计分析仅限于描述性水平。
大多数全科医生（95%；n=82）表示他们至少阅读过荷兰 GP 指南，但只有一半（50%；n=43）表示他们知道指南的内容。近一半（46%；n=39）表示他们会在为请求检测的无症状男性开具 PSA 检测前提供详细的咨询。总体而言，与其他类型的癌症筛查相比，前列腺癌筛查的重要性较低。
荷兰该地区初级保健中的临床 PSA 检测似乎总体上与限制 PSA 检测的荷兰 GP 相关指南一致。下一步将是进一步评估几种 PSA 检测策略的效果。
