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