Introduction
Prostate cancer (PCa) is a major public health concern worldwide and in
2018, 1,276,106 new cases were reported. Moreover, PCa is the second
most commonly diagnosed cancer and the second cause of cancer-related
death in Mexican men. Additionally, PCa ranks among the top ten causes
of death in Mexico’s general population, and the mortality rate expected
for 2020 is 11.5 in every 100,00 men diagnosed with PCa.1–4
In developed countries, 80% of PCa cases are detected in early stages
with a prostate-confined disease, whereas in Mexico, 80% are
advanced-stage diseases when diagnosed, halting the chance for
intent-to-cure treatments. 3,5
PCa early detection (PCa-ED) in asymptomatic men through a digital
rectal examination (DRE) and prostatic specific antigen (PSA) proved a
positive impact dropping mortality rates. Nevertheless, controversy
remains around the related risk of overtreatment and overdiagnosis. PCLO
trial failed to demonstrate a significant effect on long-term mortality
in North American men. On the other hand, the European trial ERSPC found
a long-term reduction of 21% in cancer-specific mortality rate,
remarking the need to submit 781 men to PCa-ED to detect 27 cases and
prevent one death. 6,7
Although these trials’ methodologies were different and not without
biases, pooled data from both trials were re-analysed by Tsodikov et
al., concluding that in fact, PCa-ED drops cancer-specific mortality
rate by 7-9%. 8
Current American Urological Association (AUA) guidelines recommend
providing patients with information about risk and benefits of PCa-ED to
reach a shared-decision. Nonetheless, Mexico lacks strong PCa-ED
programs which could have an impact on stage-at-diagnosis and mortality
rates. 9
Primary care physicians (PCP) have an important role in PCa-ED as they
are the ones who mainly carry it and refer patients further to urology
when needed. Current tendencies on PCa-ED among PCP in Mexico are to
date unknown. Therefore, we consider this could be a strategic target
for improvement in PCa mortality-rates in the long run. The objective of
this cross-sectional study was to assess PCP knowledge and skills on
PCa-ED trough a modified survey from Drummond et al.10