Factors associated with men's use of prostate-specific antigen screening: Evidence from Health Information National Trends Survey

Rapid uptake of prostate-specific antigen (PSA) testing has occurred in the United States despite inconclusive evidence regarding mortality benefit. 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 patients' decision making. 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. Results emphasize the relevance of patient decision making and the importance of healthcare providers in PSA testing.