Drs. Vernon Curran and Shirley
By Sharon Gray
A survey on prostate cancer screening among primary care
physicians in the province shows that the vast majority
of physicians screen patients, most commonly because of
patient request, age and family history. For patients aged
40-49 screening generally takes place every two years, but
for men age 50 and over screening takes place annually.
The survey was done by Memorial’s Satellite Research
Centre, which is funded by the Canadian Cancer Society and
the National Cancer Institute of Canada through the Sociobehavioural
Cancer Research Network.
Lead investigator Dr. Vernon Curran, co-director of the
centre and director of research with medicine’s Office
of Professional Development, said one of the important uses
of this survey will be as continuing education needs assessment
“A planning committee with representatives from the
local chapter of the Canadian Cancer Society, the medical
profession and Memorial’s Office of Professional Development
will be using the information in planning a continuing medical
education strategy for doctors in the province.”
Dr. Shirley Solberg, Nursing, director of the Satellite
Research Centre at Memorial University and a member of the
working group that prepared the report on prostate cancer
screening, said one of the mandates of the centre is to
work with the local Canadian Cancer Society chapter and
do evaluation and research that is useful to them.
“The Newfoundland and Labrador chapter suggested that
we do something around prostate cancer screening so we developed
a survey and mailed it out last summer.”
The response rate was just under 31 per cent – about
average for surveys of this type, according to Dr. Curran.
“We looked at the demographics of the respondent sample
and they were very similar to the actual demographic characteristics
of the province’s primary care physicians, so we’re
fairly confident that our sample is representative.”
“The overwhelming majority of primary care physicians
believe that screening for prostate cancer is very important
– the irony is that the majority also feel that the
evidence to support the Prostate Specific Antigen test (PSA)
and the digital rectal exam (DRE) as effective methods isn’t
clear,” said Dr. Curran.
Dr. Solberg explained that at one time the DRE identified
later prostate cancers and now that the awareness of early
screening is growing, early diagnosis is also increasing
and DRE is not picking up as many prostate cancers.
“And with the PSA test you can get high PSA levels
from conditions other than prostate cancer – for example
from prostatitis, an inflammation of the prostate. The question
is, should you do a biopsy if you have a high PSA level?”
Although prostate cancer is a serious health concern for
Canadian men, ranking as the most frequently diagnosed cancer
for men in this province, whether physicians should offer
or provide routine population-based prostate screening is
a hotly-debated question. Although there is no rigorous
scientific evidence that early detection of prostate cancer
through screening will save lives, it is still an attractive
concept for both physicians and patients.
“What the literature suggests and what we found is
that physicians most often conduct prostate cancer screening
because the patient asks for it,” said Dr. Curran.
“This suggests that the patient population is becoming
more aware of their need to take responsibility for their
The other members of the working group that prepared this
survey were Dr. Maria Mathews, Community Health, Dr. John
Church, Terry Fox Cancer Laboratory, Dr. Sharon Buehler,
honorary research professor and research assistants Julie
Wells and Tanya Lopez.
For further information on the prostate cancer screening
survey, visit www.prostatecancersupport.ca/