Personal prostate-specific antigen screening and treatment choices for localized prostate cancer among expert physicians

  • Christopher Wallis Division of Urology Department of Surgery University of Toronto
  • Douglas Cheung Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto
  • Laurence Klotz Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto
  • Venu Chalasani Department of Surgery, University of Sydney
  • Ricardo Leao Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto
  • Juan Garisto Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto
  • Gerard Morton Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto
  • Robert Nam Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto
  • Ian Tannock Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto
  • Raj Satkunasivam Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto

Abstract

Introduction: We aimed to determine the personal practices of urologists, radiation oncologists, and medical oncologists regarding prostate cancer screening and treatment using the physician surrogate method, which seeks to identify acceptable healthcare interventions by ascertaining interventions physicians select for themselves.

Methods: A hierarchical, contingent survey was developed through a consensus involving urologists, medical oncologists, and radiation oncologists. It was piloted at the University of Toronto and then circulated to urologists, radiation oncologists, and medical oncologists through professional medical societies in the U.S., Canada, Central and South America, Australia, and New Zealand. The primary outcome was physicians’ personal choices regarding prostatespecific antigen (PSA) screening and the secondary outcome was treatment selection among those diagnosed with prostate cancer.

Results: A total of 869 respondents provided consent and completed the survey. Of these, there were 719 urologists, 89 radiation oncologists, nine medical oncologists, and 53 undisclosed specialists. Most (784 of 869 respondents; 90%) endorsed past or future screening for themselves (among male physicians) or for relatives (among female physicians). Among urologists and radiation oncologists making prostate cancer treatment decisions, there was a significant correlation between physician specialty and the treatment selected (Phi coefficient=0.61; p=0.001).

Conclusions: Physicians who routinely treat prostate cancer are likely to undertake prostate cancer screening themselves or recommend it for immediate family members. Treatment choice is influenced by the well-recognized specialty bias.

Published
2017-12-01
How to Cite
Wallis, C., Cheung, D., Klotz, L., Chalasani, V., Leao, R., Garisto, J., Morton, G., Nam, R., Tannock, I., & Satkunasivam, R. (2017). Personal prostate-specific antigen screening and treatment choices for localized prostate cancer among expert physicians. Canadian Urological Association Journal, 12(2), E59-63. https://doi.org/10.5489/cuaj.4736
Section
Original Research