Prostate cancer early detection among primary care physicians in Mexico: A cross-sectional study.

AIM: This study aims to assess primary care physicians (PCPs) knowledge and skills regarding prostate cancer early detection (PCa-ED). MATERIALS AND METHODS: A survey about knowledge and skills of PCa-ED was delivered to PCP. Logistic regression analysis was conducted for the propensity of PCP to test prostatic specific antigen (PSA) on asymptomatic men. RESULTS: The survey was completed by 170 PCP. Score on risk factors knowledge was 51.5 ± 15.7% a better score was not associated with conducting PCa-ED (p = 0.674). The 40.6% answered having an institutional program on PCa-ED and 86% having access to PSA testing. Testing PSA on asymptomatic men was found in 40%. Moreover, 61.2% do not performed any digital rectal examination for PCa-ED, and this was not associated with preventing factors such as lack of space, time, and assistance (p > 0.05). Fewer years in practice and being a family medicine resident were associated with a less likelihood of testing PSA in asymptomatic men. The only associated factor in the multivariable model was having access to PSA testing (odds ratio: 3.36 confidence interval 95% 1.54-7.30) p = 0.002). CONCLUSIONS: A low rate of PCP performs PCa-ED and using concepts outside evidence-based recommendations. A national program on PCa-ED and continuing medical education for PCP are a promising strategy to improve PCa-ED.

OBJETIVO: Evaluar el conocimiento y las habilidades de los médicos de primer contacto en la detección oportuna del cáncer de próstata (DO-CaP). MÉTODO: Se aplicó una encuesta a médicos de primer contacto. Se realizó un análisis de regresión logística evaluando la propensión de los médicos a medir el antígeno prostático específico (APE) en sujetos asintomáticos. RESULTADOS: Contestaron 170 médicos y la calificación del conocimiento sobre factores de riesgo fue de 51.5 ± 15.7%, pero una mejor calificación no se asoció con realizar DO-CaP (p = 0.674). El 40.6% respondió contar con un programa institucional en DO-CaP y un 86% con acceso a la prueba de APE. El 40% medían el APE en sujetos asintomáticos. El 61.2% no ­realizaba ningún examen digital rectal para DO-CaP, y esto no se asoció con factores limitantes como falta de tiempo, espacio o asistencia (p > 0.05). Menos años en práctica y ser residente de medicina familiar disminuyeron la probabilidad de determinar el APE en asintomáticos. El único factor asociado en el análisis multivariado fue el acceso a la prueba de APE (odds ratio: 3.36; intervalo de confianza del 95%: 1.54-7.30; p = 0.002). CONCLUSIÓN: Una baja proporción de médicos de primer contacto realizan DO-CaP y utilizan conceptos alejados de la evidencia científica. Un programa nacional en DO-CaP y de educación continua para médicos de primer contacto es una estrategia prometedora para mejorar la DO-CaP.

Quality of life in patients with kidney stones: translation and validation of the Spanish Wisconsin Stone Quality of Life Questionnaire.

The Spanish version of the Wisconsin Stone Quality of Life (WISQOL) questionnaire was developed and validated. A double-back translation of the WISQOL was conducted and syntactic amendments were made, resulting in the Spanish version of the WISQOL (S-WISQOL) which then went through a readability analysis. Stone formers from two hospitals in Mexico (Merida and Monterrey) filled in the S-WISQOL and the Short Form 36 (SF36). Convergent validity was assessed by the correlation of both questionnaires. Internal consistency was evaluated by Cronbach's α, and external validity by comparing between centers. The impact of clinical settings on patients' health-related quality of life (HRQOL) scores was tested. Each hospital's institutional review board approved the project and informed consent was obtained from all participants. A total of 87 Spanish-speakers patients completed the S-WISQOL and SF36 and a good correlation was found between both (r = 0.75, p < 0.001). S-WISQOL readability was rated as "easy". Patients from Merida had longer median duration (years) with stones, more stone-related procedures, and hospitalizations, and scored lower on WISQOL (p = 0.006). Internal consistency was good as Cronbach's α coefficients ranged between acceptable and excellent. Stone-related admissions and duration of stones were inversely correlated with S-WISQOL score (- 0.254 and - 0.283, respectively; p < 0.005) but not to SF36. The S-WISQOL is an internally consistent, reliable, and valid instrument to assess HRQOL in Spanish-speaking patients with kidney stones. The S-WISQOL is generalizable as demonstrated by good external validity among centers. S-WISQOL scores can be added as an outcome for kidney stone treatments.