UICC World Cancer Congress 2006

Methods: Practice patterns were determined by a 15-item survey mailed to all 3105 health care providers who could potentially provide care for older men in the state of Iowa. Data regarding actual PSA testing practices derived from our institutional database was correlated with survey data. A multidisciplinary committee was constituted to develop consensus recommendations.

Results: We received 997 responses (32%). Ninety-six percent of primary care physicians and 97% of urologists preferred to stop PSA-based prostate cancer screening by age >=80 years, which was compatible with our institutional data. Most physicians used DRE as the first test for screening and reported a lack of patient educational materials. Older physicians and family practitioners were more likely to continue screening beyond 75 years and a majority would consent to patient requests to screen. We convened a multidisciplinary committee to propose recommendations for screening and management of prostate cancer in men >=75 years. There is a need to educate both patients and physicians to be more selective in screening in men >=75 years and to develop educational materials to facilitate these discussions. A standardized approach to prostate cancer screening and management in older men may help engender a tailored approach to managing the disease in this population, thereby decreasing health care costs and morbidity while limiting use of unnecessary therapy.