REASONS FOR THE SEARCH FOR PROSTATE EVALUATION IN PRIMARY HEALTH CARE

INTRODUCTION AND OBJECTIVE: Family physicians/general practitioners often meet apparently asymptomatic men asking for prostate examination. As prostate cancer screening seems to bring more harm than good, these users can initiate diagnostic and therapeutic waterfalls with great potential for false positives and sequelae. This work is part of a larger research that studies the search for prostate evaluation and men’s hidden agenda in Primary Health Care (PHC). Here, we try to identify reasons why men demand prostate evaluation in PHC services. METHODOLOGY: Our qualitative research involved semi-structured interviews with 16 male and female doctors working at Family Health Strategy in São Paulo and Mauá and 15 male users assisted by these professionals (men in whose consultations arose questions about prostate, erectile dysfunction or other sexual problems). In addition, we observed the five participating services. Analysis was made under the frameworks of gender and masculinities, and the notions of vulnerability, comprehensiveness and quaternary prevention. RESULTS AND CONCLUSIONS: Men seek for prostate evaluation mainly because of concern about cancer; because they associate the organ with erectile dysfunction or other genitourinary problems; hiding complaints of erectile dysfunction or other health problems; or following previous or current medical recommendation. Concern about cancer is greatly influenced by media and the involvement or recommendation of relatives or acquaintances. Understanding the motives that lead men to demand prostate examination favors the comprehensiveness of their care and helps to prevent potentially iatrogenic actions.