Practice Trends in the Management of Prostate Disease by Family Practice Physicians and General Internists: an Internet-based Survey

Objectives: To assess, using an Internet-based survey, the practice patterns of primary care physicians in the management of prostate disease and to assess the differences between family physicians and general internists. Prostate cancer and benign prostatic hyperplasia are common in the elderly population. The optimal management of these diseases is debated.

Methods: An 18-item survey was designed and administered on an Internet website. Members of the Society of General Internal Medicine and members of the Illinois, North Carolina, and New York chapters of the Academy of Family Physicians were surveyed.

Results: A total of 354 responses were obtained from 381 primary care physicians who viewed the survey web page. For patients 50 years old and older, 75% of physicians (87% of family physicians and 69% of general internists; P <0.001) recommended annual prostate cancer screening with digital rectal examination and 49% (67% of family physicians and 40% of general internists; P <0.001) recommended annual prostate cancer screening with prostate-specific antigen measurement. For patients diagnosed with prostate cancer, 76% of the primary care physicians estimated that less than one half of their patients are seen by a radiation oncologist. For the treatment and/or prevention of prostate cancer, 62% of physicians surveyed (76% of family physicians and 55% of general internists; P <0.001) believe there is a potential role for alternative herbal and nutritional therapies.

Conclusions: Compared with general internists, family physicians are more likely to screen for prostate cancer and are more likely to believe there is a role for alternative therapies for prostate cancer.