Adhesión a las guías clínicas para el screening del cáncer de próstata en Atención Primaria e identificación de áreas de mejora
Prostate adenocarcinoma is the second cause of cancer and the fifth cause of cancer mortality in men. Since introduction of prostate specific antigen (PSA) in 1979, we’ve experienced an increase in its incidence. However, the fact that is a very long latency period tumor has led to a confusion about the convenience of its diagnosis and treatment in patients at an early stage. Classically, any of the European or American urological associations has not recommended the screening of prostate cancer, allowing physicians take that decision according their own criteria related to the early opportunistic diagnosis, until the point that in 2008, the United States Preventive Services Task Force (USPSTF) recommended against its use. This statement led to an increase in the diagnosis of metastatic prostate cancer and, consequently, in its mortality. In 2019, after realizing these negative outcomes and the new evidence coming from one of the most important clinical trials in this area that studies the efficacy of the screening with PSA, the European Association of Urology released a policy paper in which they recommended prostate cancer screening for the first time supported by the significant decease in mortality rates, NNS and NNT to prevent one related-disease death. In this confusing scenario we’ve detected a high variability in primary care clinical practice in relation to this problem. Our aim is to shed light on the matter and identify improving areas that make easy the transference of the recommendations to the current clinical practice. The efficacy of our measures to fix the observed deficiencies could trigger an important advance in the early detection of prostate cancer and a decrease in the metastatic diagnosis rates, and therefore in the disease-associated mortality.