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Prostate cancer early detection among primary care physicians in southeast Mexico
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  • Mario Basulto-Martínez,
  • Jorge Ojeda-Pérez,
  • Iván Velueta-Martínez,
  • Juan Flores-Tapia,
  • Guillermo Cueto-Vega,
  • María González-Losa
Mario Basulto-Martínez
Hospital Regional de Alta Especialidad de la Península de Yucatán
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Jorge Ojeda-Pérez
Hospital Regional de Alta Especialidad de la Península de Yucatán
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Iván Velueta-Martínez
Hospital Regional de Alta Especialidad de la Península de Yucatán
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Juan Flores-Tapia
Hospital Regional de Alta Especialidad de la Península de Yucatán
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Guillermo Cueto-Vega
Hospital Regional de Alta Especialidad de la Península de Yucatán
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María González-Losa
Universidad Autónoma de Yucatán
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Abstract

Background: Prostate cancer early detection (PCa-ED) trough prostatic specific antigen (PSA) and digital rectal examination (DRE) has proved to lower mortality rates and should be carry out by primary care physicians (PCP). In Mexico, 80% of prostate cancers are detected in advanced-stages but PCP trends on PCa-ED remain unknown. Aim: To assess PCP knowledge and skills regarding PCaED. Materials and Methods: A self-administrating survey about the knowledge and skills of PCa-ED was created and delivered to PCP. Logistic regression analysis was conducted for the propensity of PCP to test prostatic specific antigen (PSA) on asymptomatic men. Results: The survey was completed by 170 PCP. The 13.5% answered being “not-well trained”. Score on risk factors knowledge was 51.5±15.7% but a score above the mean was not associated with testing PSA on asymptomatic men (p=0.674). The 40.6% answered having an institutional program on PCa-ED and 86% having access to PSA testing. Testing PSA on asymptomatic men was found in 40%. Moreover, 61.2% do not perform any digital rectal examination for PCa-ED, and this was not associated with preventing factors like lack of space, time, and assistance (p>0.05). Fewer years in practice and being a family medicine resident was associated with a less likelihood of testing PSA in asymptomatic men whereas having access to PSA testing and an institutional program on PCa-ED, increased the probability. The only significantly associated factor in the multivariable model was to have access to PSA testing [OR: 3.36 (CI 95% 1.54-7.30) p=0.002]. Conclusions: A low proportion of PCP in southeast Mexico performs PCa-ED and uses concepts outside evidence-based recommendations. A national program on PCa-ED and continuing medical education for PCP is a promising strategy to improve PCa-ED.

Peer review status:POSTED

26 Mar 2020Submitted to Journal of Evaluation in Clinical Practice
27 Mar 2020Assigned to Editor
27 Mar 2020Submission Checks Completed