US Primary Care Physicians' Prostate Cancer Screening Practices: A Vignette-Based Analysis of Screening Men at High Risk.
BACKGROUND
Limited information exists on primary care physicians' (PCPs) use of the prostate-specific antigen (PSA) test by patient risk category. We describe PCP responses to hypothetical patient scenario (PS) involving PSA testing among high-risk asymptomatic men.


METHODS
Data were from the 2007 to 2008 National Survey of Primary Care Physicians' Practices Regarding Prostate Cancer Screening. PS#1: healthy 55-year-old white male with no family history of prostate cancer; PS#2: healthy 45-year-old African American male with no family history of prostate cancer; and PS#3: healthy 50-year-old male with a family history of prostate cancer. Data were analyzed in SAS/SUDAAN.


RESULTS
Most PCPs indicated that they generally discuss the possible benefits/risks of PSA testing with the patient and then recommend the test (PS#1-PS#3 range, 53.4%-68.7%;P< .001); only about 1% reported discussing and then recommending against the test. For PS#3, compared to PS#1 and #2, PCPs were more likely to discuss and recommend the test or attempt to persuade the patient who initially declines the test. For PS#3, all clinicians generally would order/discuss the PSA test and not rely on the patient to ask.


CONCLUSIONS
Clinicians treat family history as an important reason to recommend, persuade, and initiate PSA testing.
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Sun Hee
SH
Rim
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Ingrid J
IJ
Hall
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Thomas B
TB
Richards
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Trevor D
TD
Thompson
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Lisa C
LC
Richardson
Ross Holmes Group, LLC, Raleigh, NC, USA.
Louie E
LE
Ross
North Carolina Mecklenburg County Health Department, Charlotte, NC, USA.
Marcus
M
Plescia
health literacy; primary care physician practices; prostate cancer; prostate cancer screening; prostate-specific antigen test use