Prostate cancer screening in primary care

Background. Little is known about the actual frequency with which men have prostate screening in primary care settings, nor are the determinants of sc reening understood. Methods. We examined the records of 50 consecutive primary care office visi ts by men aged 50 or older. Men were asked to complete a brief questionnair e outlining their previous use of prostate screening services and the facto rs that influenced screening. Results. Screening in the previous year with digital rectal examination (DR E) and prostate specific antigen (PSA) was reported by 46% and 30% of respo ndents, respectively. Most respondents (86%) had heard of prostate screenin g and most (78%) believed it was effective. The only factor predictive of s creening with DRE in multivariate analysis was a doctor's discussion of scr eening (odds ratio, 4.8). Two factors were predictive of PSA screening-know ing someone who had prostate cancer (odds ratio, 12.8) and advancing age (o dds ratio [per year], 1.1). Conclusions. Many men are not having annual prostate screening. Men who wer e older, who reported knowing someone with prostate cancer, and whose docto rs discussed screening; were more likely to have been screened in the past year.