By Jennifer Hinkel, NCCN e-Bulletin Editor-in-Chief
Questions in the most recent NCCN Trends™ survey polled clinicians worldwide regarding their perceptions of routine breast cancer and prostate cancer screening. The survey asked respondents to indicate how strongly they agreed or disagreed with various statements about screening approaches. In the previous issue of NCCN eBulletin, an article examined the breast cancer screening data from that survey. This issue presents survey data on prostate cancer screening.
Data from the survey indicated that 57% of clinician respondents (n = 1,343) “agreed” or “strongly agreed” with the statement “Screen ALL men starting at 50 years of age” for prostate cancer. Only 36% “agreed” or “strongly agreed” with the statement “Limit screening to men at high risk based on established risk factors.” Nearly 80% of responding clinicians disagreed or strongly disagreed with the statement “PSA should not be used for PC screening.” (See Figure 1)
Clinicians were also asked about their treatment preferences for prostate cancer. More than 40% of the participating clinicians responded that they recommend a form of radiation therapy for a patient with localized prostate cancer who has no comorbidities, a low risk of recurrence, and a life expectancy of greater than 10 years. (See Figure 2)
In comparing the opinions of physicians, advanced practitioners and nurses regarding prostate cancer screening, physicians were less likely to agree or strongly agree that all men starting at 50 years of age should be screened. However, physicians were more likely than advanced practitioners and nurses to be in favor of limited screening, either limiting routine screening to men 50 to 75 years of age with a 10 to 15 year life-expectancy (52% agreeing or strongly agreeing) or limiting screening to men at high risk (34% agreeing or strongly agreeing). In all cases, fewer than ten percent of clinicians felt that PSA should not be used for prostate cancer screening. (See Figure 3)
An international comparison of responses from four regions (United States, Asia, Latin America, and Europe) demonstrated various geographic differences in opinion regarding prostate cancer screening with PSA. The only region for which more than 50% of respondents agreed or strongly agreed that all men starting at 50 years of age should be screened was Latin America. European clinicians were the most likely to agree or strongly agree that PSA should not be used for prostate cancer screening (13% of European respondents), while only 4% of United States respondents agreed or strongly agreed with that statement. United States and European respondents were equally likely to agree or strongly agree to the statement “Limit screening to men 50 – 75 years of age who have a 10 – 15 year life-expectancy.” In general, European clinicians appeared to agree more with a limited approach to screening, while United States clinicians tended to agree with a wider approach. (See Figure 4)
In summary, data from this survey offers information on various perspectives among oncology clinicians regarding how prostate cancer screening should be conducted and what interventions they would be most likely to use for a patient with localized prostate cancer.
About NCCN Trends™ Surveys: NCCN Trends™ surveys are brief, monthly surveys distributed by e-mail and completed by a convenience sample of clinicians who are registered to access information on NCCN.org. In a typical month, between 1,300 and 1,800 clinicians worldwide participate in NCCN Trends™ surveys. All participants receive a summary report describing the aggregate results of surveys which they complete.