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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Clinical Genitourinary Cancer
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Mortality results from a randomized prostate-cancer screening trial.N Engl J Med. 2009; 360: 1310-1319
- Screening and prostate-cancer mortality in a randomized European study.N Engl J Med. 2009; 360: 1320-1328
- Information needs of men regarding prostate cancer screening and the effect of a brief decision aid.Patient Educ Couns. 2004; 54: 345-351
- Screening for prostate cancer: US Preventive Services Task Force recommendation statement.Ann Intern Med. 2012; 157: 120-134
- Promoting informed decisions about cancer screening in communities and health care systems.Am J Prev Med. 2004; 26: 67-80
- Personalised risk communication for informed decision making about taking screening tests.Cochrane Database Syst Rev. 2006; : CD001865
- Are physicians discussing prostate cancer screening with their patients and why or why not? A pilot study.J Gen Intern Med. 2007; 22: 901-907
National Cancer Institute. Health Information National Trends Survey. Vol 2015. Available at: https://hints.cancer.gov/instrument.aspx. Accessed: April 17, 2017.
- Stata Statistical Software: Release 13.StataCorp LP, College Station, TX2013
- Primary care physician PSA screening practices before and after the final US Preventive Services Task Force recommendation.Urol Oncol. 2014; 32: 41.e23-41.e30
- Declines in prostate cancer incidence after changes in screening recommendations.Arch Intern Med. 2012; 172: 1267-1268
- Factors associated with men's use of prostate-specific antigen screening: evidence from Health Information National Trends Survey.Prev Med. 2005; 40: 461-468
- Prostate cancer screening and informed decision-making: provider and patient perspectives.Prostate Cancer Prostatic Dis. 2011; 14: 155-161
- To screen or not to screen, when clinical guidelines disagree: primary care physicians' use of the PSA test.Prev Med. 2004; 38: 182-191
- Physicians' attitudes about shared decision making for prostate cancer screening.Fam Med. 2011; 43: 260-266
- The relationship between prostate cancer knowledge and beliefs and intentions to attend PSA screening among at-risk men.Patient Educ Couns. 2009; 74: 244-249
- Supporting informed decision making online in 20 minutes: an observational Web-log study of a PSA test decision aid.J Med Internet Res. 2010; 12: e15
- Shared decision making in clinical medicine: past research and future directions.Am J Prev Med. 1999; 17: 285-294
- Shared decision making for treatment of cancer: challenges and opportunities.J Oncol Pract. 2014; 10: 206-208
- Informed decision making: what is its role in cancer screening?.Cancer. 2004; 101: 1214-1228
- Prospect theory: an analysis of decision under risk.Econometrica. 1979; 47: 263-291
- Patients' interest in reading their medical record: relation with clinical and sociodemographic characteristics and patients' approach to health care.Arch Intern Med. 2004; 164: 793-800
- Modifying unwarranted variations in health care: shared decision making using patient decision aids.Health Aff (Millwood). 2004; : VAR63-VAR72
- Untangling the Web—the impact of Internet use on health care and the physician-patient relationship.Patient Educ Couns. 2007; 68: 218-224
- Shared decision making to improve care and reduce costs.N Engl J Med. 2013; 368: 6-8
- PCORI at 3 years—progress, lessons, and plans.N Engl J Med. 2014; 370: 592-595
- Physician communication regarding prostate cancer screening: analysis of unannounced standardized patient visits.Ann Fam Med. 2013; 11: 315-323
- Patient-centered discussions about prostate cancer screening: a real-world approach.Ann Intern Med. 2010; 153: 661-665
- A simple schema for informed decision making about prostate cancer screening.Ann Intern Med. 2014; 161: 441-442
- Decision aids for people facing health treatment or screening decisions.Cochrane Database Syst Rev. 2017; 4: CD001431
- Trials of decision aids for prostate cancer screening: a systematic review.Am J Prev Med. 2007; 33: 428-434.e411
- Health literacy and shared decision making for prostate cancer patients with low socioeconomic status.Cancer Invest. 2001; 19: 684-691
- Enhanced support for shared decision making reduced costs of care for patients with preference-sensitive conditions.Health Aff (Millwood). 2013; 32: 285-293
- A user's manual for the IOM's ‘Quality Chasm’ report.Health Aff (Millwood). 2002; 21: 80-90
- Early detection of prostate cancer: AUA Guideline.J Urol. 2013; 190: 419-426
- American Cancer Society guideline for the early detection of prostate cancer: update 2010.CA Cancer J Clin. 2010; 60: 70-98
- Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up.Lancet. 2014; 384: 2027-2035
- Overdiagnosis and overtreatment of prostate cancer.Eur Urol. 2014; 65: 1046-1055
- The US Preventive Services Task Force 2017 draft recommendation statement on screening for prostate cancer. An invitation to review and comment.JAMA. 2017; 317: 1949-1950
- Prostate cancer incidence and PSA testing patterns in relation to USPSTF screening recommendations.JAMA. 2015; 314: 2054-2061
- Prostate-specific antigen screening after 2012 US Preventive Services Task Force recommendations.JAMA. 2015; 314: 2077-2079
- Expected population impacts of discontinued prostate-specific antigen screening.Cancer. 2014; 120: 3519-3526
- A literature review of cost-effectiveness analyses of prostate-specific antigen test in prostate cancer screening.Expert Rev Pharmacoecon Outcomes Res. 2013; 13: 327-342
- The effect of numerical statements of risk on trust and comfort with hypothetical physician risk communication.Med Decis Making. 2004; 24: 265-271
- Explaining risks: turning numerical data into meaningful pictures.BMJ. 2002; 324: 827-830
Published online: May 09, 2017
Accepted: May 1, 2017
Received in revised form: April 18, 2017
Received: March 6, 2017
© 2017 Elsevier Inc. All rights reserved.