title: The influence of physician recommendation on prostate-specific antigen screening.
abstract: OBJECTIVE
  Prostate-specific antigen (PSA) screening is controversial, and little is known regarding a physician's effect on a patient's decision to undergo screening. This study's objective was to evaluate the effect of a patient's understanding of the risks and benefits of screening compared to the final recommendation of the provider on the patient's decision to undergo PSA screening.
  
  
  METHODS
  Using the 2012 Behavioral Risk Factor Surveillance System, men older than 55 years who did not have a history of prostate cancer/prostate "problem" and who reported a PSA test within the preceding year were considered to have undergone screening. The percentages of men informed and not informed of the risks and benefits of screening and the percentage men receiving recommendations for PSA screening from their provider were reported. Multivariable complex-sample logistic regression calculated the odds of undergoing screening.
  
  
  RESULTS
  In all, 75% of men were informed of screening benefits; however, 32% were informed of screening risks. After being informed of both, 56% of men opted for PSA screening if the provider recommended it, compared with only 21% when not recommended. Men receiving a recommendation to undergo PSA testing had higher odds of undergoing screening (odds ratio [OR] = 4.98, 95% CI: 4.53-5.48) compared with those who were only informed about screening benefits (OR = 2.40, 95% CI: 2.18-2.65) or risks (OR = 0.92, 95% CI: 0.86-0.98). Significant limitations include recall and nonresponse bias.
  
  
  CONCLUSIONS
  Patients' decision to undergo or forgo PSA screening is heavily influenced by the recommendation of their physician; it is imperative that physicians are cognizant of their biases and facilitate a shared decision-making process.
authors.affiliation: VUI Center for Outcomes Research, Analytics and Evaluation, Henry Ford Health System, Detroit, MI.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pucheril
authors.affiliation: VUI Center for Outcomes Research, Analytics and Evaluation, Henry Ford Health System, Detroit, MI.
authors.forename: Deepansh
authors.initials: D
authors.lastname: Dalela
authors.affiliation: VUI Center for Outcomes Research, Analytics and Evaluation, Henry Ford Health System, Detroit, MI.
authors.forename: Jesse
authors.initials: J
authors.lastname: Sammon
authors.affiliation: VUI Center for Outcomes Research, Analytics and Evaluation, Henry Ford Health System, Detroit, MI.
authors.forename: Akshay
authors.initials: A
authors.lastname: Sood
authors.affiliation: Division of Urologic Oncology and Center for Surgery and Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
authors.forename: Maxine
authors.initials: M
authors.lastname: Sun
authors.affiliation: Division of Urologic Oncology and Center for Surgery and Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.affiliation: VUI Center for Outcomes Research, Analytics and Evaluation, Henry Ford Health System, Detroit, MI.
authors.forename: Mani
authors.initials: M
authors.lastname: Menon
authors.affiliation: VUI Center for Outcomes Research, Analytics and Evaluation, Henry Ford Health System, Detroit, MI. Electronic address: FABDOLL1@hfhs.org.
authors.forename: Firas
authors.initials: F
authors.lastname: Abdollah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians; D010818:Practice Patterns, Physicians'; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis
chemical_list: D017430:Prostate-Specific Antigen
keywords: Physician influence; Prostate-specific antigen; Screening