The State of Pre-Screening Discussions About PSA Testing Following Implementation of the 2012 USPSTF Task Force Statement

To determine if the quality of pre-screening discussions has changed following release of the USPSTF statement against prostate cancer screening.

This cross-sectional study utilized the 2012 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) surveys. Respondents were categorized based on the year in which they responded to the BRFSS Survey. Quality of pre-screening discussion was operationalized as having discussed: only advantages, only disadvantages, both advantages and disadvantages, or neither. Race/ethnicity, education level, income, insurance status, and having a PSA level actually drawn after pre-screening counseling served as confounders in our multivariate analysis.

Among 217,053 men in the analytic sample, 37% were told about only advantages of PSA screening compared to 30% of men who were advised about both advantages and disadvantages. Men who were told about neither advantages or disadvantages were more likely to be Hispanic, not graduate high school, have low income and not have insurance. Controlling for covariates, men in 2014 were significantly more likely to have undergone PSA testing without having discussed either advantages or disadvantages than men in 2012.

Comprehensive pre-screening discussions about advantages and disadvantages of PSA testing are critical to informed decision-making about prostate cancer screening. Disparities not only exist with regard to the quality of pre-screening discussions that patients receive from their providers prior to PSA testing across categories of race/ethnicity, education, income and insurance status, but these disparities became more substantial between 2012 and 2014. Further investigation is warranted to elicit more specific reasons behind these variations.

Urology. 2017 Mar 16 [Epub ahead of print]

George A Turini, Annie Gjelsvik, Joseph F Renzulli

Minimally Invasive Urology Institute, Division of Urology, Brown University, Providence, RI. Electronic address: ., Department of Epidemiology, Brown University School of Public Health, Providence, RI., Minimally Invasive Urology Institute, Division of Urology, Brown University, Providence, RI.