Original Study| Volume 15, ISSUE 6, e977-e985, December 2017

What Have Patients Been Hearing From Providers Since the 2012 USPSTF Recommendation Against Routine Prostate Cancer Screening?

  • Mohammad Rifat Haider
    Department of Health Services Policy and Management, University of South Carolina, Columbia, SC

    Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
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  • Zaina P. Qureshi
    Address for correspondence: Zaina P. Qureshi, PhD, MPH, MS, DMM, RPh, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 915 Greene St, Columbia, SC 29208. Fax: 803-777-1836
    Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC

    Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC

    William Jennings Bryan Dorn VA Medical Center, Columbia, SC
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  • Ronnie Horner
    Department of Health Services Policy and Management, and Institute for the Advancement of Healthcare, University of South Carolina, Columbia, SC
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  • Daniela B. Friedman
    Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC
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  • Charles Bennett
    Department of Clinical Pharmacy and Outcomes Sciences, and Medication Safety, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC
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      In this study we aimed to determine the relationship between prostate-specific antigen (PSA)-related information obtained from the provider and PSA test uptake. With recent focus on patient-provider communication (PC) and the guidelines recommending against PSA tests for prostate cancer (PCa), PC regarding the PSA test might affect PSA screening rates.

      Materials and Methods

      We used the fourth edition of the Health Information National Trends Survey, a nationally-representative US survey on the use of cancer-related information. The survey was conducted in 3 cycles: October 2011 to January 2012 (cycle 1); October 2012 to January 2013 (cycle 2); September 2013 to October 2013 (cycle 3). Logistic regression was used to study the effect of PC on respondents' uptake of the PSA test.


      Most of the respondents were 51 to 65 years old, white, with college or higher education, were married, and had health insurance. PC regarding the PSA test greatly increased the chances of screening for PCa using the PSA test in all 3 cycles (odds ratio [OR], 2.51 [95% confidence interval (CI), 2.03-3.10] in cycle 1; OR, 3.50 [95% CI, 2.51-4.88] in cycle 2; OR, 2.69 [95% CI, 2.02-3.58] in cycle 3).


      Our study showed that PC increased the likelihood of patients undergoing PSA screening. In light of the 2012 US Preventive Services Task Force guidelines recommending against screening for PCa, PC seemed to have an opposite effect. Although updated PC that educates patients on the risks and benefits of PSA screening is needed, patients classically overemphasize benefits and underemphasize risks—which might increase rather than decrease PSA screening rates.


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