[Attitude of primary care physicians to early detection of prostatic cancer through prostate-specific antigen].
OBJECTIVE
To study the attitude of primary care doctors when a high (> or = 4 ng/ml) prostate-specific antigen (PSA) is found and to examine the variables linked to a prostate biopsy and the diagnosis of prostate cancer (PC).


METHODS
Descriptive, observational study.


METHODS
Urban health district.


METHODS
Ninety-four men not previously diagnosed with PC who in 1998 had a PSA figure > or = 4 ng/ml. The list was obtained from the pertinent laboratory.


METHODS
The following variables were gathered from review of clinical records: family background of PC, age, PSA figure, reason for request for PSA (if not given, it was considered a screening), referral to the urologist, rectal touch, transrectal echography, prostate biopsy and final diagnosis.


RESULTS
Average age was 70 (SD, 9.31). The reason for requesting PSA was: urine symptoms in 25 (26.6%), other signs or symptoms in 25 (26.6%), request of patient in 2 cases (2.1%) and screening in 42 (44.7%). Rectal touch took place in 16 cases. Twenty-nine people were referred for examination to the urologist. 36 patients had an echography and biopsy. Variables linked to the prostate biopsy in the logistic model were: higher value of the PSA (OR 1.1; 95% CI, 1.03-1.18), being older (OR 0.92; CI, 0.87-0.98) and rectal touch performed (OR 3.58; CI, 1.02-12.51). Ten cases of PC were diagnosed.


CONCLUSIONS
The most common reason for a PSA request was screening. Prostate biopsy was not requested for 58 men. A primary care guide to action concerning PC diagnosis in cases of PSA > or = 4 ng/ml would be useful.
Oller Colom
M
M
mollerc@meditex.es
Jiménez Navarrete
S
S
Hidalgo García
A
A
Calvo Rosa
E
E
Pérez Herrera
M M
MM
Castellanos Duarte
R M
RM
Simón Muela
C I
CI
Asens Mampel
N
N
Duaso Allué
I
I
Gascón Gazulla
S
S
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001706:Biopsy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011320:Primary Health Care; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology
D017430:Prostate-Specific Antigen