Discussions with healthcare providers about prostate-specific antigen testing: evidence from the Behavioral Risk Factor Surveillance System in the USA

Abstract

Objectives To explore (1) effect of socio-demographic and personal characteristics on extent of discussions between men and healthcare providers about prostate-specific antigen (PSA) testing and (2) effect of discussions on PSA testing. Methods This retrospective cross-sectional study analyzed data collected from the 2012 wave of the Behavioral Risk Factor Surveillance System. A discussion with healthcare providers about PSA testing was considered as a dependent variable. Baseline category logistic model was used to measure the effect of socio-demographic, personal variables on three levels of discussions (complete, partial and none). Logistic regression was used to test association between levels of discussion and whether a person had PSA test. Key findings Among 133 040 men, 84 996 (63.9%) said their providers discussed advantages of PSA with them, 94 818 (71.3%) said providers never discussed disadvantages of PSA testing. Highest level of educational attainment, age, health insurance, recommendation for a PSA test and having a unique personal provider were associated with discussing about PSA testing. Odds of not having a PSA test was at least 6.84 times more for those who had no discussion compared with those who had discussed either advantages or disadvantages and was less by at least 81.4% for those who discussed both advantages and disadvantages compared with those who discussed nothing. Conclusions Most men and providers did not discuss the disadvantages of PSA testing. Men with higher educational attainment, being older and having a unique personal provider were more likely to have discussed PSA testing with their providers. Discussions with providers had a positive impact on PSA testing.