Prostate cancer early detection among primary care physicians in
southeast Mexico
Abstract
Background: Prostate cancer early detection (PCa-ED) trough prostatic
specific antigen (PSA) and digital rectal examination (DRE) has proved
to lower mortality rates and should be carry out by primary care
physicians (PCP). In Mexico, 80% of prostate cancers are detected in
advanced-stages but PCP trends on PCa-ED remain unknown. Aim: To assess
PCP knowledge and skills regarding PCaED. Materials and Methods: A
self-administrating survey about the knowledge and skills of PCa-ED was
created and delivered to PCP. Logistic regression analysis was conducted
for the propensity of PCP to test prostatic specific antigen (PSA) on
asymptomatic men. Results: The survey was completed by 170 PCP. The
13.5% answered being “not-well trained”. Score on risk factors
knowledge was 51.5±15.7% but a score above the mean was not associated
with testing PSA on asymptomatic men (p=0.674). The 40.6% answered
having an institutional program on PCa-ED and 86% having access to PSA
testing. Testing PSA on asymptomatic men was found in 40%. Moreover,
61.2% do not perform any digital rectal examination for PCa-ED, and
this was not associated with preventing factors like lack of space,
time, and assistance (p>0.05). Fewer years in practice and
being a family medicine resident was associated with a less likelihood
of testing PSA in asymptomatic men whereas having access to PSA testing
and an institutional program on PCa-ED, increased the probability. The
only significantly associated factor in the multivariable model was to
have access to PSA testing [OR: 3.36 (CI 95% 1.54-7.30) p=0.002].
Conclusions: A low proportion of PCP in southeast Mexico performs PCa-ED
and uses concepts outside evidence-based recommendations. A national
program on PCa-ED and continuing medical education for PCP is a
promising strategy to improve PCa-ED.