Factors associated with menʹs use of prostate-specific antigen screening: evidence from Health Information National Trends Survey

Background. Rapid uptake of prostate-specific antigen (PSA) testing has occurred in the United States despite inconclusive evidence regarding mortality benefit. Methods. We examined data (n = 927) from the 2003 Health Information National Trends Survey to assess prevalence of self-reported PSA use and its association with patientsʹ decision making. Results. Over half (55.2%) the sample reported ever having had a PSA test. Men aged 65–74 (OR = 2.53, 1.49–4.31), with some college (OR = 2.41, 1.22–4.77) or college degrees (OR = 5.01, 2.53–9.90) were more likely to have had PSA tests, while men without health insurance (OR = 0.32, 0.12–0.88) or a usual source of care (OR = 0.35, 0.22–0.54) were less likely. In a model including healthcare provider communication and information seeking, men who reported that providers involved them in decisions (OR = 1.76, 1.02–3.03) and recommended PSA (OR = 236.3, 70.5–791.4) were more likely to have had the tests. Men aged 65–74 (OR = 2.30, 1.33–4.00), with college degrees (OR = 2.91, 1.45–5.82), and greater information attention/seeking (OR = 1.23, 1.07–1.40) were more likely to report PSA recommendations, while those without usual care were less likely (OR = 0.37, 0.22–0.64). Men without usual care (OR = 0.38, 0.20–0.71) and Hispanic men (OR = 0.40, 0.19–0.85) were less likely to report that healthcare providers involved them in healthcare decisions. Conclusions. Results emphasize the relevance of patient decision making and the importance of healthcare providers in PSA testing.