Screening for carcinoma of the prostate: a GP based study
Article first published online: 26 NOV 2008
© 1994 British Journal of Urology
British Journal of Urology
Volume 74, Issue 1, pages 64–71, July 1994
How to Cite
KIRBY, R.S., KIRBY, M.G., FENELEY, M.R., McNICHOLAS, T., McLEAN, A. and WEBB, J.A.W. (1994), Screening for carcinoma of the prostate: a GP based study. British Journal of Urology, 74: 64–71. doi: 10.1111/j.1464-410X.1994.tb16549.x
- Issue published online: 26 NOV 2008
- Article first published online: 26 NOV 2008
- Prostate cancer;
- prostate specific antigen;
- transrectal ultrasound
Objective To examine the feasibility and acceptability of screening for cancer of the prostate by digital rectal examination (DRE), prostate specific antigen (PSA) determination and subsequent transrectal ultrasound (TRUS) in selected patients in a single general practice in Hertfordshire.
Subjects and methods A total of 568 of 856 men aged 55 to 70 accepted an invitation for a health check which included screening for prostate cancer. Of these, 80 individuals with either a raised PSA level or an abnormal DRE underwent TRUS. In 29 individuals biopsies were taken, 11 of which confirmed the presence of adenocarcinoma of the prostate giving an overall detected prevalence of 2%. Of the 11 tumours identified by screening, two were T1Mo, four were T2Mo, two were T3Mo and three were T3M1.
Results To assess the acceptability of the screening exercise a postal questionnaire was sent to all 568 participants: 83% replied and 69% reported no concern. Of the 67 individuals who had undergone TRUS, 69% reported discomfort. A total of 448 (95%) of respondents declared that they would be prepared to undergo the screening exercise again.
Conclusion Screening for prostate cancer would seem to be technically feasible and generally acceptable. However, there is a considerable false positive rate in the PSA range 4 ng/ml to 10 ng/ml, particularly among men with clinical evidence of benign prostatic hyperplasia. To establish the true benefit of screening a large-scale prospective controlled study will be necessary.