France-Trends in screening for prostate cancer

Abstract:

Background:

Screening for prostate cancer is still in debate. In France, there is no financial barrier for individuals to be screened with the prostate-specific antigen (PSA) test, and there is no recommendation for mass screening.

Methods:

Two nationwide observational studies were carried out in France.

The first one, EDIFICE 1, was conducted in 2005 among a representative sample of 1504 subjects aged between 40 and 75 years and a representative sample of 600 general practitioners (GPs).
The second one, EDIFICE 2, was conducted in 2008 with the same methodology.

Results:

General population: In 2005, 36% of the interviewed male population aged between 50 and 75 years declared having undergone a screening test, compared to 49% in 2008 (OR = 1.63 CI95% 1.25; 2.12).

Prostate cancer screening increased in all age groups, however, the most significant increase can be observed in the population aged between 50 and 54 years: 18% in 2005 versus 35% in 2008 (OR = 2.43 CI95% 1.31; 4.52). This trend for increasing testing will probably be confirmed in the future since 57% of males never screened plan to undergo a test, and only 16% of those who did screening plan to stop.

The expected participation in the future will be close to 70%.

Physicians:

In 2005, 58% of GPs systematically recommended prostate cancer screening for their male consultants ages 50 to 74, in 2008 the figure is 65% (OR = 1.32 CI95%1.04; 1.66).
For prostate cancer screening, a GP's gender has no significant impact. Systematic recommendation for both breast and colorectal cancer screening has an impact on recommending prostate cancer screening as well; OR = 2.9 (CI95% 2.0-4.4) and OR = 2.0 (CI95% 1.3-3.2) respectively. The GP's age is not associated with a higher rate of systematic recommendation.

Conclusions:

We have observed in France a significant growth in prostate cancer screening: more persons screened, more often, at a younger age. Despite the lack of consistent evidence, persons and GPs exposed to mass communication and campaign for breast and colorectal cancer screening might infer that screening is valuable for other conditions.

Trends in screening for prostate cancer


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