Research by students at Charles Sturt University (CSU) in Orange has exposed a city-country divide in the screening of men over 50 for prostate cancer.

 

The disease is estimated to affect one in seven men by the age of 75 but experts are divided over the need for regular screening in the absence of any overt symptoms.

 

The Royal College of General Practitioners does not recommend “routine testing” for the disease, but does recommend GPs use both the prostate-specific antigen blood test and a digital rectal examination if a patient asks to be screened.

 

Students Ms Claire Elligett, Ms Emily Schivener and Ms Lucy Sutherland, who are in their final year of CSU’s Bachelor of Clinical Science, surveyed GPs from Northern Sydney, Western NSW and Far West NSW local health districts.

 

GPs were asked about their prostate screening frequency, methods and rationale for asymptomatic male patients over the age of 50.

 

The study divided the GPs into low-level screeners (who test 25 per cent of patients or less), mid-level screeners (who test 26-75 per cent of patients) and high-level screeners (who test 76 per cent of patients or more).

 

The research found 80 per cent of low-level screeners were rural GPs, while 75 per cent of high-level screeners were metropolitan GPs.

 

Some of the rural GPs surveyed attributed their low-levels of screening to the reluctance of patients to undergo the digital rectal examination, while others said their high workload precluded them from testing unless the patient exhibited risk factors.

 

Almost 20 per cent of the rural GPs surveyed said they used the prostate-specific antigen test alone to screen patients for the disease in spite of the college recommendation, and also attributed this to negative patient attitudes toward the digital rectal examination.

 

The study recommended further research be conducted into the different approaches to prostate cancer screening between rural and metropolitan GPs and the creation of more specific guidelines for screening to ensure all patients receive an equal level of care.