Knowledge and practice of prostate cancer screening among general practitioners in Malaysia: a cross-sectional study.
OBJECTIVE
Screening for prostate cancer remains controversial. General practitioners (GPs) play an important role in assisting men to make an informed decision on prostate cancer screening. The aim of this study was to determine the knowledge and practice of prostate cancer screening among private GPs in Malaysia.


METHODS
A cross-sectional study.


METHODS
Private general practices in Selangor, Malaysia.


METHODS
311 randomly selected full-time private GPs were recruited between September 2013 and January 2014.


METHODS
Questionnaires were distributed to the GPs via postal mail and clinic visits. The main outcomes were: knowledge of prostate cancer risk factors and screening tests; GPs' prostate cancer screening practices; and factors influencing GPs' decision to screen for prostate cancer. Associations between covariates and propensity to screen for prostate cancer were determined using logistic regression.


RESULTS
The response rate was 65%. The proportion of GPs who overestimated the positive predictive values of prostrate-specific antigen (PSA), digital rectal examination (DRE) and a combination of PSA and DRE was 63%, 57% and 64%, respectively. About 49.5% of the respondents would routinely screen asymptomatic men for prostate cancer; of them, 94.9% would use PSA to screen. Male GPs who would consider having a PSA test performed on themselves were six times more likely to screen asymptomatic men than GPs who would not have the test (OR=6.88, 95% CI 1.40 to 33.73), after adjusting for age and duration of practice.


CONCLUSIONS
GPs overestimated the accuracy of PSA in prostate cancer screening. Their intention to screen for prostate cancer themselves predicted their propensity to screen their patients for prostate cancer. This finding highlights the potential of using a new approach to change GPs' screening practices via addressing GPs' own screening behaviour.
Faculty of Medicine, Department of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Abdul Malik
AM
Tun Firzara
Faculty of Medicine, Department of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Chirk Jenn
CJ
Ng
PREVENTIVE MEDICINE; PRIMARY CARE
Fam Med. 2011 Apr;43(4):260-6
21499999
Aust Fam Physician. 2013 Dec;42(12):904-8
24324997
J Natl Cancer Inst. 2011 Dec 21;103(24):1827-39
22158127
BJU Int. 2006 Nov;98(5):996-1000
17034601
J Natl Cancer Inst. 1999 Aug 4;91(15):1310-6
10433620
J Am Board Fam Pract. 2003 Mar-Apr;16(2):95-101
12665174
BMC Fam Pract. 2005 Jun 09;6(1):24
15946386
Ann Intern Med. 2012 Jul 17;157(2):120-34
22801674
N Engl J Med. 2009 Mar 26;360(13):1310-9
19297565
J Urol. 2013 Aug;190(2):419-26
23659877
Br J Gen Pract. 2011 Nov;61(592):e684-91
22054323
Am J Clin Nutr. 2008 May;87(5):1405-13
18469265
Ann Intern Med. 2008 Mar 18;148(6):435-48
18252677
Ann Intern Med. 2013 May 21;158(10):761-9
23567643
Prostate Cancer Prostatic Dis. 2012 Jun;15(2):189-94
22343837
BMC Fam Pract. 2009 Jan 12;10:3
19138385
BMC Health Serv Res. 2013 Oct 11;13:408
24119237
BMJ. 2004 Oct 30;329(7473):1013
15514347
BMC Med Inform Decis Mak. 2008 Sep 12;8:38
18789150
J Natl Cancer Inst. 2006 Apr 19;98(8):529-34
16622122
N Z Med J. 2003 Jun 20;116(1176):U476
12835804
Eur Urol. 2008 Sep;54(3):581-8
18423977
Urol Oncol. 2012 Mar-Apr;30(2):155-60
20800514
BMJ. 2012 Jan 09;344:d7894
22232535
Am J Public Health. 2010 Apr;100(4):693-701
19608952
Fam Pract. 1999 Dec;16(6):621-6
10625141
J Cancer Educ. 2005 Fall;20(3):162-6
16122364
J Cancer Educ. 2013 Dec;28(4):679-83
23963724
Lancet. 2014 Dec 6;384(9959):2027-35
25108889
Am J Manag Care. 2000 Mar;6(3):315-24
10977432
J Natl Cancer Inst. 2012 Jan 18;104(2):125-32
22228146
N Engl J Med. 2009 Mar 26;360(13):1320-8
19297566
Can Fam Physician. 2005 Dec;51:1658-9
16926946
CA Cancer J Clin. 2010 Mar-Apr;60(2):70-98
20200110
Prostate. 2008 Oct 1;68(14):1582-91
18646000
BJU Int. 2004 Jul;94(1):51-6
15217430