A national survey of radiation oncologists and urologists on recommendations of prostate-specific antigen screening for prostate cancer

Authors


Abstract

Objective

  • To assess recommendations for prostate-specific antigen (PSA) screening in a national survey of radiation oncologists and urologists following the recent USA Preventive Services Task Force (USPSTF) grade D recommendation.

Methods

  • A random sample of 1366 radiation oncologists and urologists were identified from the American Medical Association Physician Masterfile.
  • From November 2011 to April 2012, a mail survey was sent to query PSA screening recommendations for men at average risk of prostate cancer for the following age groups: 40–49, 50–59, 60–69, 70–74, 75–79 and ≥80 years.
  • Multivariable logistic regression was used to test for differences in PSA-based screening recommendations by physician characteristics.

Results

  • Response rates were similar at 52% for radiation oncologists and urologists (P = 0.92).
  • Overall, 51.5% of respondents recommended PSA-based screening for men aged 40–49 years, while nearly all endorsed it for those aged 50–74 years (96.1% for 50–59, 97.3% for 60–69, and 87.7% for 70–74 years).
  • However, screening recommendations decreased to 43.9% and 12.8% for men aged 75–79 and ≥80 years, respectively.
  • On multivariable analysis, urologists were more likely to recommend screening for men aged 40–49 (odds ratio [OR] 3.09; P < 0.001) and 50–59 years (OR 3.81; P = 0.01), but less likely for men aged 75–79 (OR 0.66; P = 0.01) and ≥80 years (OR 0.45; P = 0.002) compared with radiation oncologists.

Conclusion

  • While radiation oncologists and urologists recommended PSA screening for men aged 50–69 years, there was less agreement about screening for younger (40–49 years old) and older (≥70 years) men at average risk for prostate cancer.

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