ATTITUDES OF EUROPEAN UROLOGISTS TO EARLY PROSTATIC-CARCINOMA .2. ATTITUDE TO THERAPY AND TO SCREENING EXAMINATIONS

The attitudes of 656 European urologists toward therapy of localized p rostatic cancer (PC) and screening examinations of the male population for PC were surveyed. Eighty percent of the urologists would offer cu rative therapy to a 60-year-old patient with localized PC, while 20% w ould offer watchful waiting or hormonal therapy. The choice of curativ e therapy was not correlated to the grade of the cancer. Radical prost atectomies were offered 2.5 times as often as external beam radiothera py. 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 t his would decrease mortality from prostate cancer. A majority would in clude digital rectal examination, prostate-specific antigen and sympto m evaluation in a screening program. Agreement among urologists from d ifferent European countries regarding the handling of early prostatic cancer is poor. Large regional differences were observed with a more a ctive attitude to therapy and screening in southern and central Europe . Attitudes to screening and to therapy, however, were only weakly cor related. In conclusion, it seems paradoxal that many urologists who wo uld offer curative therapies to patients with localized PC would not t ake steps to diagnose this disease via screening of population.