A national survey of medical students' beliefs and knowledge in screening for prostate cancer

BACKGROUND: Today's medical students are being educated at a time when there are no evidence-based guidelines for prostate cancer screening. OBJECTIVE: To examine medical students' knowledge and beliefs concerning prostate cancer screening and specific determinants for their beliefs. DESIGN, SETTING, AND PARTICIPANTS: One thousand six hundred and forty four students were sampled at 20 medical schools using a web-based, cross-sectional survey. MAIN OUTCOME MEASURES: Basic knowledge and beliefs about prostate cancer testing, epidemiology, and therapy were ascertained. RESULTS: Four of 8 knowledge items were answered incorrectly by 50% or more of students. Seven of 8 students believe that early diagnosis from screening can improve survival from prostate cancer. Second- and third-year students were more likely than fourth-year students to believe that the digital rectal exam (DRE) and the prostate-specific antigen test were accurate, adjusted odds ratio (AOR) 1.8; 95% confidence interval (CI), 1.2 to 2.7 and 1.7; 1.3 to 2.2 for second and third years, respectively, for the DRE. Black and Hispanic students were no more likely than white students to agree that early screening diagnosis improves survival, but blacks were more likely to agree with screening black or Hispanic men (AOR 7.8; 95% CI, 5.3 to 11.4 and 3.2; 2.2 to 4.7, respectively). More knowledgeable students were less likely to believe in the benefit of early detection and the accuracy of the prostate-specific antigen (AOR 0.3; 95%CI, 0.2 to 0.5). CONCLUSIONS: Medical students generally are very optimistic about the benefits of screening for prostate cancer. Increased knowledge about prostate cancer is associated with a more conservative view of screening. Other predictors are independent of this knowledge.