title: [Attitude of primary care physicians to early detection of prostatic cancer through prostate-specific antigen].
abstract: 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.
authors: mollerc@meditex.es
authors: M
authors: M
authors: Oller Colom
authors: S
authors: S
authors: Jiménez Navarrete
authors: A
authors: A
authors: Hidalgo García
authors: E
authors: E
authors: Calvo Rosa
authors: M M
authors: MM
authors: Pérez Herrera
authors: R M
authors: RM
authors: Castellanos Duarte
authors: C I
authors: CI
authors: Simón Muela
authors: N
authors: N
authors: Asens Mampel
authors: I
authors: I
authors: Duaso Allué
authors: S
authors: S
authors: Gascón Gazulla
mesh_terms: 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
chemical_list: D017430:Prostate-Specific Antigen