Attitudes of European urologists to early prostatic carcinoma, II. Attitude to therapy and to screening examinations.

The attitudes of 656 European urologists toward therapy of localized prostatic cancer (PC) and screening examinations of the male population for PC were surveyed. Eighty percent of the urologists would offer curative therapy to a 60-year-old patient with localized PC, while 20% would offer watchful waiting or hormonal therapy. The choice of curative therapy was not correlated to the grade of the cancer. Radical prostatectomies were offered 2.5 times as often as external beam radiotherapy. The number of radical prostatectomies performed was considered to be increasing by 56% of the urologists surveyed, decreasing by 10% and stable by 34%. Fifty-five percent thought that screening for prostate cancer should be undertaken in their country, but only 35% believed this would decrease mortality from prostate cancer. A majority would include digital rectal examination, prostate-specific antigen and symptom evaluation in a screening program. Agreement among urologists from different European countries regarding the handling of early prostatic cancer is poor. Large regional differences were observed with a more active attitude to therapy and screening in southern and central Europe. Attitudes to screening and to therapy, however, were only weakly correlated. In conclusion, it seems paradoxal that many urologists who would offer curative therapies to patients with localized PC would not take steps to diagnose this disease via screening of the male population.