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February 19, 2004


Screening usually driven by patient request
Prostate awareness increasing


Drs. Vernon Curran and Shirley Solberg.
Photo by HSIMS
Drs. Vernon Curran and Shirley Solberg.

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 information.

“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 own health.”

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 or


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