Determinants of prostate-specific antigen test use in prostate cancer screening by primary care physicians
O. J. Austin, S. Valente, L. A. Hasse and J. R. Kues
Department of Family Medicine, University of Cincinnati, Ohio 45239, USA.
OBJECTIVE: To identify determinants of prostate-specific antigen (PSA) test
use in prostate cancer screening by primary care physicians. DESIGN:
Self-administered, confidential surveys were mailed to 800 Ohio primary
care physicians. A second mailing to nonrespondents was sent a month later.
Surveys included questions on beliefs, attitudes, knowledge, and reasons
for PSA prostate cancer screening. RESULTS: The response rate of usable
surveys was 51% (n=408). More than half (55%) of the respondents reported
using the PSA test for screening often or always. Multiple regression
analysis showed physicians' reported belief that PSA screening is the
standard of care in one's community was the strongest direct predictor of
use (beta=.32; P<.001). Other direct predictors of PSA test use included
physician feeling about the test (beta=.28; P<.001), patient requests
for the test (beta=.19; P<.001), age of patient (beta=.11; P< or
=.003), and recommendation of specialty or other organizations (beta=.12;
P=.001). CONCLUSIONS: Although PSA prostate cancer screening has yet to be
proved definitely effective in decreasing mortality or morbidity from the
disease, more than half of Ohio primary care physicians surveyed reported
regular screening. The rationale for such screening seems to be
multifaceted, and, thus, changes in physician behavior probably will be
difficult to achieve.
