US Primary Care Physicians' Prostate Cancer Screening Practices: A Vignette-Based Analysis of Screening Men at High Risk.
Sun Hee Rim, Ingrid J Hall, Thomas B Richards, Trevor D Thompson, Lisa C Richardson, Louie E Ross, Marcus Plescia
Author Information
Sun Hee Rim: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Ingrid J Hall: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Thomas B Richards: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Trevor D Thompson: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Lisa C Richardson: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Louie E Ross: Ross Holmes Group, LLC, Raleigh, NC, USA.
Marcus Plescia: North Carolina Mecklenburg County Health Department, Charlotte, NC, USA.
BACKGROUND: Limited information exists on primary care physicians' (PCPs) use of the prostate-specific antigen (PSA) test by patient risk category. We describe PCP responses to hypothetical patient scenario (PS) involving PSA testing among high-risk asymptomatic men. METHODS: Data were from the 2007 to 2008 National Survey of Primary Care Physicians' Practices Regarding Prostate Cancer Screening. PS#1: healthy 55-year-old white male with no family history of prostate cancer; PS#2: healthy 45-year-old African American male with no family history of prostate cancer; and PS#3: healthy 50-year-old male with a family history of prostate cancer. Data were analyzed in SAS/SUDAAN. RESULTS: Most PCPs indicated that they generally discuss the possible benefits/risks of PSA testing with the patient and then recommend the test (PS#1-PS#3 range, 53.4%-68.7%; < .001); only about 1% reported discussing and then recommending against the test. For PS#3, compared to PS#1 and #2, PCPs were more likely to discuss and recommend the test or attempt to persuade the patient who initially declines the test. For PS#3, all clinicians generally would order/discuss the PSA test and not rely on the patient to ask. CONCLUSION: Clinicians treat family history as an important reason to recommend, persuade, and initiate PSA testing.
