Prostate cancer, screening and the generalist physician.

Abstract

The generalist physician (family physician or general internist) provides primary care services and coordinates the care of other specialists for most Americans. These physicians develop continuous relationships with patients that can span decades. This therapeutic relationship is an important aspect of the services that generalist physicians provide. Generalist physicians serve as the first line of defense in screening for cancer and other serious health conditions. Prostate cancer is a prevalent and important condition. However, generalist physicians will encounter 10 times as many older men who will die of heart disease than of prostate cancer. Until more conclusive evidence is available to support the aggressive diagnosis and treatment of early stage prostate cancer, the generalist physician should refrain from screening for prostate cancer without counseling men about the risks, benefits, alternatives and uncertainties of early diagnosis and treatment of prostate cancer.