PROSTATE-CANCER SCREENING - A PHYSICIAN SURVEY IN MISSOURI

This study investigated prostate cancer screening practices using pros tate specific antigen testing (PSA), digital rectal examination (DRE), and transrectal ultrasonography (TRUS) by primary care physicians in Missouri. In 1993, a mail survey was sent to a stratified random sampl e of 750 physicians whose primary specialty was general practice, fami ly practice, or internal medicine. Three separate mailings resulted in an overall adjusted response rate of 60 percent. Ninety-five percent of physicians were more inclined to use PSA compared with three years previously, with only 45 percent of physicians more inclined to use DR E. An increase in the use of PSA following a negative DRE was reported by 85 percent and a greater inclination to use TRUS following a posit ive PSA was reported by 90 percent Eighty-six percent agreed with the American Cancer Society (ACS) guidelines on prostate cancer screening. Using logistic regression adjusted across levels of demographic and p ractice factors, prevalence odds ratios were derived with results indi cating that agreement with ACS guidelines and being in private practic e are strong predictors of a physician's inclination to routinely scre en asymptomatic patients for prostate cancer. Our findings have provid ed baseline information on prostate cancer screening in Missouri and s uggest that primary care physicians view PSA testing as a useful proce dure and appear to be using it in a manner similar to the general patt ern seen across the country.