Prostate Cancer Screening: Knowledge, Attitudes, and Practices by Medical Doctors in Portugal

Abstract

Opportunistic prostate cancer (PCa) screening is common worldwide, with physicians playing an important role in its uptake and consequences. This study explores the knowledge, attitudes, and practices of family doctors and urologists in Portugal regarding PCa screening. A national online survey was conducted between November 2020 and February 2021. Family doctors and urologists were reached by email through their national medical associations, for a total of 596 and 63 participants from each group, respectively. Urologists considered themselves more updated with PCa screening practices than family doctors (93.0% vs. 73.1%; p < 0.001). Family doctors were more likely to consider older age (97.2% vs. 90.9%; p = 0.025) and smoking (80.6% vs. 31.7%; p < 0.001) as risk factors for PCa. Most urologists reported following the European Association of Urology Guidelines for PCa screening (90.9%), while family doctors preferred the National Guidelines (73.9%). A higher proportion of urologists believed early diagnosis is essential for improving PCa prognosis (92.9% vs. 67.9%; p < 0.001). Urologists were more likely to recommend prostate-specific antigen (PSA) testing for age group-eligible males (always or almost always: 77.2% vs. 20.4%; p < 0.001) and to perform digital rectal examination (never or rarely: 3.5% vs. 96.2%; p < 0.001). Overall, 65.1% of doctors believed that magnetic resonance imaging could improve the diagnosis of PCa in patients with high PSA levels. Family doctors and urologists differed in their knowledge, attitudes, and practices regarding PCa screening. The latter are more interventive and believe more in the benefits of PCa screening.

Keywords: Early detection of cancer; Family physicians; Prostate-specific antigen; Prostatic neoplasm; Urologists.