"The Neighbour Around the Corner" A Model for An Early Detection of Prostate Cancer in the Gastroeneterology Unit

Background: According to the guidelines of the American Cancer Society, men over the age of 50 should have their PSA level checked and undergo a rectal examination, for early detection of prostate cancer. Goals: To evaluate the feasibility of palpation of the prostate gland, during routine rectal examinations, in patients undergoing lower digestive system examinations in the Gastroenterology unit, and follow-up by family physician. Methods: Men, over the age of 50, referred for a lower digestive system examination. During the rectal examination, the gastroenterologist palpated the prostate gland. Demographic details, relevant medical history, rectal examination results and recommendations from the gastroenterologist for follow-up, were collected via a questionnaire. Patients with pathological results were referred to their family physician for follow-up. These patients were prospectively surveyed by telephone. Results: Included, 554 consecutive males age 50 - 79 who had not previously been checked for prostate cancer. In 145 (26.1%) of the patients the gastroenterologist found a pathologic prostate gland, 134 (92%) of them, turned back to their family physician. Fifty eight (43.3%) remained under the family physician surveillance. Seventy six (56.7%) were referred to urologists. Three of them (3.9%) were diagnosed as suffering from prostate cancer at early stage. A significant relationship was found between prostate findings and age and origin but not education (p = 0.01, p=0.017) Conclusions: The suggested model
is applicable, easy to implement and can be introduced with minimal investment of resources. A high patient and family physician compliance was observed.