Primary Care Providers' Response to the US Preventive Services Task Force Draft Recommendations on Screening for Prostate Cancer

Abstract

Editorial Comment: Will anyone listen to the recommendation of the task force? These authors queried 123 practitioners in the Johns Hopkins Community Physicians practice, which in 2010 evaluated approximately 40,000 men 40 years or older who were eligible for prostate cancer screening. When asked how they thought the draft recommendations would change their approach, 2% said they would no longer order prostate specific antigen (PSA) testing, 22% said they would be much less likely do so, 39% said they would be somewhat less likely do so and 37% said they would not change their screening practices. However, even among those clinicians who agreed with the draft recommendations fewer than half (41%) stated that they would no longer order routine PSA testing or would be less likely to do so. Reasons that physicians would not change their practice included patient expectation for them to continue screening (75%); lack of time to explain changes (67%); fear of malpractice litigation (54%); and discomfort with uncertainty (42.5%). Finally, the clinicians who were most likely to believe that the draft recommendations would change their practice were also the providers who were least likely to report routinely ordering PSA in the past year. At the same time another article demonstrated that despite the U.S. Preventive Services Task Force recommendations against prostate cancer screening in men 75 years or older, PSA screening rates did not change.