Prostate-Specific Antigen Testing Initiation and Shared Decision-Making: Findings from the 2000 and 2015 National Health Interview Surveys

Journal of the American Board of Family Medicine: JABFM

Helen Ding^1¹  Iman Martin^1²  Thomas B. Richards^1³  Jun Li^1⁴ 

[1] DB Consulting Group INC, Silver spring, MD (HD);Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, (SK, PMM)^1;Division of Cancer Prevention, National Cancer Institute, Bethesda, (IM);From Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (JL, TBR)

关键词: Decision Making;    Early Detection of Cancer;    Logistic Regression;    Prevalence;    Prostate Cancer;    Prostate-Specific Antigen;   

DOI  :  10.3122/jabfm.2018.04.170448

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Purposes: Despite recommendations against prostate cancer screening with prostate-specific antigen (PSA) tests, about one-fourth of men age ≥40 years received PSA tests in 2015. This study aimed to answer 3 questions for men who had a PSA test in the past year: (1) What percentage of these men received the test first suggested by physicians? (2) What factors were associated with physician-initiated PSA testing (PIPT) versus patient/someone else-initiated testing? (3) What percentage of patients ever had shared decision-making when tests were initiated by physicians? Methods: We analyzed the 2000 and 2015 National Health Interview Survey data. We calculated age-standardized prevalence of PIPT for both years. For 2015, we used logistic regression to calculate adjusted prevalence ratios for PIPT. We also calculated the prevalence of ever discussing both advantages and disadvantages. Results: The age-standardized prevalence of PIPT was significantly higher in 2015 (84.9%) than in 2000 (72.3%). In 2015, nearly 90% of PSA screenings for men aged ≥70 years were suggested by physicians. PIPT was positively associated with 2 or more comorbid conditions and number of patient visits to the doctor. Less than one-third of men reported they had ever participated in a discussion of advantages and disadvantages of PSA testing. Conclusions: The majority of men who had PSA testing in the past year reported that their physicians were the first to suggest testing, including men aged ≥70 years. Our study also points to the challenges and needs in conducting shared decision-making before PSA testing in clinical practice.

【 授权许可】

CC BY