Has there been a change in practice of screening for prostate cancer with prostate-specific antigen in Ontario?

Objective: To determine whether there has been a change in the rate of screening in Ontario in 2002 compared to 1995. Methods: A questionnaire was mailed to 520 physicians, associated with PSA records selected randomly from the database of a large community laboratory. Physicians were asked to consult their records as to the reasons for PSA testing. Results: There were 285 usable responses from 520 mailings (response rate 55%), mostly (91%) from family or general practice. Reasons for testing, expressed as proportions of responses, were as follows (this study, 1995 study and P value for the differences): screening for prostate cancer (74%, 63%; P = 0.059), diagnosis of urinary symptoms (30%, 40%; P = 0.027), follow-up of a medical procedure or drug therapy (14%, 32%; P = 0.001), confirmation of a previous PSA result (14%, 6%; P = 0.015) and other reasons (7%, 8%; P = 0.73). Of those records with screening as one reason for testing, 80% vs. 66% (P = 0.003) indicated it was the only reason; 86% vs. 73% (P = 0.003) indicated that it was part of a routine examination, and 54% vs. 64% (P = 0.052) indicated that the test was requested by the patient. Conclusion: These findings are consistent with increased screening for prostate cancer with PSA.