title: PSA screening: determinants of primary-care physician practice patterns.
abstract: BACKGROUND
  The effect of practice guidelines and the European Randomised Screening for Prostate Cancer (ERSPC) and Prostate, Lung, Colorectal and Ovarian (PLCO) trials on PSA screening practices of primary-care physicians (PCPs) is unknown.
  
  
  METHODS
  We conducted a national cross-sectional on-line survey of a random sample of 3010 PCPs from July to August 2010. Participants were queried about their knowledge of prostate cancer, PSA screening guidelines, the ERSPC and PLCO trials, and about their PSA screening practices. Factors associated with PSA screening were identified using multivariable linear regression.
  
  
  RESULTS
  A total of 152 (5%) participants opened and 89 completed the on-line survey, yielding a response rate of 58% for those that viewed the invitation. Eighty percent of respondents correctly identified prostate cancer risk factors. In all, 51% and 64% reported that they discuss and order PSA screening for men aged 50-75 years, respectively. Fifty-four percent were most influenced by the US Preventative Services Task Force (USPSTF) guidelines. Also, 21% and 28% of respondents stated that their PSA screening practices were influenced by the ERSPC and PLCO trials, respectively. Medical specialty was the only variable associated with propensity to screen, with family medicine physicians more likely to use PSA screening than internists (β=0.21, P=0.02).
  
  
  CONCLUSIONS
  Half of the physicians surveyed did not routinely discuss PSA screening with eligible patients. The impact of the ERSPC and PLCO trials on PSA screening practices was low among US PCPs. USPSTF recommendations for PSA screening continue to be the strongest influence on PCPs' propensity to use PSA screening.
authors.affiliation: Division of Urology, The Children's Hospital of Philadelphia (work conducted while at the University of California, San Francisco, CA, USA), Philadelphia, PA, USA.
authors.forename: G E
authors.initials: GE
authors.lastname: Tasian
authors.forename: M R
authors.initials: MR
authors.lastname: Cooperberg
authors.forename: M B
authors.initials: MB
authors.lastname: Potter
authors.forename: J E
authors.initials: JE
authors.lastname: Cowan
authors.forename: K L
authors.initials: KL
authors.lastname: Greene
authors.forename: P R
authors.initials: PR
authors.lastname: Carroll
authors.forename: J M
authors.initials: JM
authors.lastname: Chan
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D058007:Physicians, Primary Care / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D017430:Prostate-Specific Antigen