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Letters |20 October 2015

The Roles of Providers and Patients in the Overuse of Prostate-Specific Antigen Screening in the United States

Fangjian Guo, MD, PhD; Di He, MS

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch, Galveston, Texas; and David Eccles School of Business, The University of Utah, Salt Lake City, Utah.

    Note: All data from NHANES (National Health and Nutrition Examination Survey) used in this study were collected by the National Center for Health Statistics for the Centers for Disease Control and Prevention.

    Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention, National Center for Health Statistics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, or National Institutes of Health.

    Primary Funding Source: Dr. Guo is currently supported by an institutional training grant (National Research Service Award T32HD055163) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.

    Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0220.

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Background: Most guidelines recommend against using prostate-specific antigen (PSA) testing to screen a population for prostate cancer on the basis of findings from 2 large clinical trials—the U.S. PLCO (Prostate, Lung, Colorectal, and Ovarian) Cancer Screening Trial (1) and the ERSPC (European Randomized Study of Screening for Prostate Cancer) (2). However, this test is still widely used for screening in the United States, and understanding why this practice persists is important.
Objective: To measure the percentage of PSA tests in U.S. adult men that are done on a physician's recommendation versus a patient's request.
Methods and Findings: The National Health Interview Survey collects information through an annual survey of people in their homes, using a complex, stratified, multistage sample design to provide nationally representative data. The survey oversamples black, Hispanic, and Asian persons to increase the precision of the estimates for these populations. Each participant provides verbal consent for survey participation. We used data from the 2013 survey to measure the experiences of 7814 men (aged 40 to 70 years) without prostate cancer during the 12 months before the survey.
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Guo F, He D. The Roles of Providers and Patients in the Overuse of Prostate-Specific Antigen Screening in the United States. Ann Intern Med. 2015;163:650–651. doi: 10.7326/L15-5150

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Published: Ann Intern Med. 2015;163(8):650-651.

DOI: 10.7326/L15-5150

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