General practitioners' attitudes to screening for prostate and testicular cancers

Objective: To assess general practitioners' (GPs') perceptions of the effectiveness of screening for prostate and testicular cancers, and their self-reported levels of screening for these conditions in the light of the conflicting advice available to GPs, and a lack of evidence to support testing for either of these cancers. Design: A questionnaire sent to all 101 GPs in the Division of General Practice, southern Tasmania. Results: There was an 82% response rate to the questionnaire, GPs had an accurate knowledge of the epidemiology of these cancers. Of 57 GPs who thought that digital rectal examination was an effective screening test for prostate cancer, 56 said they should screen asymptomatic patients but only 37 said they actually did screen. The corresponding results for prostate-specific antigen screening were 45, 26 and 13, respectively. For testicular cancer screening, 59 GPs thought that clinical examination of the testes was an effective screening test, 55 said they should screen asymptomatic patients but only 21 said they actually did screen. Corresponding results for testicular self-examination were 56, 57 and 21, respectively. Conclusions: Many GPs are uncertain about the tests available for screening for prostate and testicular cancers. Some think they should screen, but few do so consistently. Clear and precise evidence-based guidelines for screening for these conditions are necessary.