Prostate cancer screening practices: differences between clinic and private patients.

ABSTRACT

How often prostate cancer screening tests are conducted in general practice is unknown. It is known that at the primary care level, health care delivered to uninsured and Medicaid patients and to privately insured patients differs. We investigated the frequency of digital rectal examination and prostate-specific antigen testing in a clinic (an internal medicine clinic) and a faculty private practice population at The Mount Sinai Hospital over a period of one year. A total of 165 male patients over 40 years of age were asked to respond to a survey questionnaire; 142 interviews were completed (62 private and 80 clinic). Chart and computer database review were used to record the last serum prostate-specific antigen test performed. There was no difference in age distribution between the two groups. The private practice patients were more likely to be insured and college educated, whereas the clinic patients were more likely to have no more than an eighth-grade education and to receive Medicaid. The two groups did not differ in frequency of digital examination within the past year. Private patients were six times more likely than clinic patients to have had prostate-specific antigen screening and seven times more likely to receive both of the recommended prostate screening tests within the past year. Results also showed that 25% of all patients were not screened for cancer by digital rectal examination. Study of a larger population is recommended to further corroborate these findings.