Association between features of patient-provider discussions and routine prostate-specific antigen testing

In PLoS One, Joshua Liao and colleagues examine the impact of provider recommendations and presence of a personal doctor on routine prostate cancer screening with PSA testing. Although the US Preventive Services Task Force recommends against routine prostate cancer screening, specialty organizations support screening via shared decision making between providers and selected patients. The investigators used the 2013 Behavioral Risk Factor Surveillance System to identify 1,737 men surveyed about their PSA testing decisions. More than 70% of respondents reported some form of discussion with providers about testing and most underwent screening in accordance with provider recommendations. In multivariable analyses, men whose providers had never recommended PSA test were less likely to receive screening, and patients who did not identify a personal doctor in their care were less likely to undergo testing. These findings suggest that providers and policymakers should be aware of how the content and context of communication with patients, beyond discussions of risks and benefits, can influence routine PSA testing behaviors.