ATTITUDES OF EUROPEAN UROLOGISTS TO EARLY PROSTATIC-CARCINOMA .1. DIAGNOSTIC WORK-UP ON SUSPECTED PROSTATIC-CANCER CASES

The diagnostic work-ups of 656 European urologists on theoretical case s of suspected early prostatic carcinoma were surveyed. The diagnostic work-ups varied considerably among the urologists. There was strong a greement that digital rectal examination (DRE) and prostate-specific a ntigen (PSA) should be used routinely in these cases, but there was a lack of agreement concerning the use of transrectal ultrasound examina tion (TRUS), prostate biopsies and bone scan. However, the use of TRUS , bone scan and biopsies was correlated positively to the PSA level an d negatively to age (p < 0.001), but was not correlated to whether the patient was asymptomatic or suffered from prostatism. Ninety-two perc ent of the urologists would perform biopsies if a palpable lesion were present. If the PSA was elevated, 22% would use biopsies if it was 7 ng/l, 62% if it was 15 ng/l and 83% if it was 35 ng/l. These results i ndicate that a majority of European urologists would attempt to diagno se prostatic cancer with biopsies only when results of DRE and PSA pre dict a high risk that the cancer is no longer organ-confined.