Abstract
Background and Objectives: Despite significant progress in prostate cancer research, screening of the disease has remained controversial. From a socio-epidemiological perspective, little is known of patients' experiences and general practitioners' perceptions on this issue especially in Iran. The purpose of this study was to explore the perceptions and experiences of Iranian patients and general practitioners about the early detection of prostate cancer. Method: A mixed method design was adopted in two phases. Phase 1 (qualitative) used a grounded theory approach to interview a purposive sample of twelve men with prostate cancer and twelve general practitioners. Data were analyzed using MAXqda2 software. The findings from the quantitative phase informed the design of a survey (Phase 2) on 615 Iranian general practitioners. The quantitative data was analyzed using SPSS (V16). Findings: Phase I revealed a continuous social process in the detection of prostate cancer from men and GP's perspective. For men, the detection process contained three stages of "making sense of the illness", "seeking help", and "seeking a diagnosis". For GPs, four phenomena including "observation", "communication", "reflection" and "making decision" were developed. "Seeking to know the illness" and "interacting to assess the risk of prostate cancer" emerged from men and GPs' data. The results from Phase 2 showed that socio-cultural barriers and triggers influenced GPs' interactions. According to the GPs, men's lack of knowledge was the main barriers, which resulted in delay seeking care, but the wife had a significant role in persuading their spouses to seek help. Lack of a clear policy about screening was an important barrier in the detection of the disease. Conclusion: The results provide useful insights about patients and general practitioners' beliefs and perceptions on prostate cancer screening. Additionally, the findings could provide directions for policy makers to take socio-cultural aspects of prostate cancer into account in future health policy' planning. The findings point to the future development primary cancer care within the Iranian health system.