A national survey of radiation oncologists and urologists on recommendations of prostate-specific antigen screening for prostate cancer.
OBJECTIVE
To assess recommendations for prostate-specific antigen (PSA) screening in a national survey of radiation oncologists and urologists following the recent USA Preventive Services Task Force (USPSTF) grade D recommendation.


METHODS
A random sample of 1366 radiation oncologists and urologists were identified from the American Medical Association Physician Masterfile. From November 2011 to April 2012, a mail survey was sent to query PSA screening recommendations for men at average risk of prostate cancer for the following age groups: 40-49, 50-59, 60-69, 70-74, 75-79 and ≥80 years. Multivariable logistic regression was used to test for differences in PSA-based screening recommendations by physician characteristics.


RESULTS
Response rates were similar at 52% for radiation oncologists and urologists (P = 0.92). Overall, 51.5% of respondents recommended PSA-based screening for men aged 40-49 years, while nearly all endorsed it for those aged 50-74 years (96.1% for 50-59, 97.3% for 60-69, and 87.7% for 70-74 years). However, screening recommendations decreased to 43.9% and 12.8% for men aged 75-79 and ≥80 years, respectively. On multivariable analysis, urologists were more likely to recommend screening for men aged 40-49 (odds ratio [OR] 3.09; P < 0.001) and 50-59 years (OR 3.81; P = 0.01), but less likely for men aged 75-79 (OR 0.66; P = 0.01) and ≥80 years (OR 0.45; P = 0.002) compared with radiation oncologists.


CONCLUSIONS
While radiation oncologists and urologists recommended PSA screening for men aged 50-69 years, there was less agreement about screening for younger (40-49 years old) and older (≥70 years) men at average risk for prostate cancer.
Yale University School of Medicine, Department of Urology, New Haven, CT, USA; Yale University, Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER), New Haven, CT, USA.
Simon P
SP
Kim
R Jeffrey
RJ
Karnes
Paul L
PL
Nguyen
Jeanette Y
JY
Ziegenfuss
R Houston
RH
Thompson
Leona C
LC
Han
Nilay D
ND
Shah
Marc C
MC
Smaldone
Cary P
CP
Gross
Igor
I
Frank
Christopher J
CJ
Weight
Timothy J
TJ
Beebe
Jon C
JC
Tilburt
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D018787:Radiation Oncology; D011795:Surveys and Questionnaires; D014481:United States; D014572:Urology
D017430:Prostate-Specific Antigen
outcomes; prostate cancer; prostate-specific antigen; screening; survey