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Published on: August 1, 2019
PSA screening: determinants of primary-care physician practice patterns.
G E Tasian1, M R Cooperberg, M B Potter
1Division of Urology, The Children's Hospital of Philadelphia (work conducted while at the University of California, San Francisco, CA, USA), Philadelphia, PA, USA.
Prostate Cancer and Prostatic Diseases
|February 21, 2012
Summary
Primary care physicians (PCPs) show low awareness of prostate cancer screening trials. US Preventative Services Task Force (USPSTF) guidelines most influence PSA screening practices, while European Randomised Screening for Prostate Cancer (ERSPC) and Prostate, Lung, Colorectal and Ovarian (PLCO) trial impacts are minimal.
Area of Science:
- Urology
- Primary Care Medicine
- Public Health
Background:
- The influence of clinical practice guidelines and major prostate cancer screening trials on primary-care physicians' (PCPs) screening behaviors remains unclear.
- Understanding these influences is crucial for effective prostate cancer screening implementation.
Purpose of the Study:
- To assess the impact of practice guidelines and the European Randomised Screening for Prostate Cancer (ERSPC) and Prostate, Lung, Colorectal and Ovarian (PLCO) trials on PSA screening practices among PCPs.
- To identify factors associated with PCPs' decision-making regarding PSA screening.
Main Methods:
- A national cross-sectional online survey was conducted with 3010 PCPs.
- Participants were surveyed on their knowledge of prostate cancer, PSA screening guidelines, ERSPC and PLCO trials, and their screening practices.
- Multivariable linear regression was used to identify factors associated with PSA screening.
Main Results:
- Only 89 PCPs completed the survey (58% response rate among those who viewed the invitation).
- 51% discussed and 64% ordered PSA screening for men aged 50-75.
- The US Preventative Services Task Force (USPSTF) guidelines most influenced screening (54%), while ERSPC (21%) and PLCO (28%) had lower impact.
- Family medicine physicians were more likely to screen than internists.
Conclusions:
- A significant proportion of PCPs do not routinely discuss PSA screening with eligible patients.
- The ERSPC and PLCO trials have had a limited impact on PSA screening practices among US PCPs.
- USPSTF recommendations remain the primary driver for PCPs' PSA screening decisions.
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