Factors influencing primary care physicians’ decision to order prostate-specific antigen (PSA) test for men without prostate cancer

Figures & data

Table I. Demographic and practice characteristics for physicians (N = 305).

Characteristic	Mean (SD)
Age, years	53 (7.1)
Sex	N (%)
Male	162 (53)
Female	143 (47)
Practice location*
University town	99 (32)
Other cities	192 (63)
Practice type*
Health centers	184 (60)
Hospitals	9 (3)
Private practice	24 (8)
Other	55 (18)
Experience as a physician, years
< 5	1 (0.3)
5–10	20 (6)
10>	280 (93)
Proportion of cancer patients
< 10%	281 (94)
Approx. 25%	14 (4)
Approx. 50%	1 (0.3)
75%>	4 (1)

*Data is not available for all participants.

Table II. Physicians’ use of PSA test and their intentions regarding both taking (only male physicians) and ordering the test (N = 305).

How often do you order PSA-testing for your patients?	N^1 (%)
Often	34 (12)
Occasionally	218 (73)
Seldom	43 (14)
Never	4 (1)
For how many patients have you ordered PSA-testing during the last year?
< 50	203 (69)
50–100	72 (24)
100–150	11 (4)
150>	10 (3)
Do you follow the debate regarding PSA-testing?
Not at all/rarely	13 (4)
Occasionally	195 (64)
Always	96 (32)
Is ordering of PSA-tests discussed among your colleagues?
No/rarely	46 (15)
Occasionally	182 (61)
Always	72 (24)
Does your colleagues’ opinion about PSA-testing affect your attitude to the test?
No, absolutely not	43 (14)
Moderately	211 (71)
Yes, absolutely	46 (15)
Would you take the PSA-test (only male physicians)?
No, absolutely not	49 (30)
Maybe	86 (53)
Yes, absolutely	27 (17)

¹Data was not available for all participants.

Table III. Probability of ordering PSA-test for men without PCa within different age groups.

Item	Age groups
How likely is it that you would order a PSA-test for your male patients?	< 40 yrs	40–50 yrs	50–60 yrs	60–70 yrs	> 70 yrs
Median	1.00	2.00	3.00	3.00	3.50
How likely is it that you would order a PSA-test for your male patients?	< 40 yrs N* (%)^1	40–50 yrs N* (%)^1	50–60 yrs N* (%)^1	60–70 yrs N* (%)^1	> 70 yrs N* (%)^1
Extremely low Very low Low Moderate High Very high Extremely high	234 (77) 45 (15) 9 (3) 6 (2) 5 (1.7) 1 (0.3) 3 (1)	117 (39) 85 (28) 47 (16) 23 (8) 18 (6) 5 (2) 6 (2)	64 (21) 46 (15) 44 (15) 62 (21) 44 (15) 22 (7) 17 (6)	56 (18) 39 (13) 37 (12) 56 (18) 48 (16) 48 (16) 20 (7)	73 (24) 41 (14) 37 (12) 47 (16) 37 (12) 39 (13) 28 (9)

*Data was not available for all participants.

¹Proportion of physicians reporting a high probability of ordering PSA-test.

Table IV. The extent to which different variables influence a physicians’ decision to order a PSA- test for men within different age groups (Range 1–7).

Items	Median
How likely is it that the following factors influence you when ordering a PSA-test?
Physical symptoms:
Clinical suspicion of prostate cancer	7
Suspected hereditary	6
Clinical suspicion of an enlarged prostate gland	6
Patient has urinary problem	4
Patient has back pain	4
Patient has defecation problems	3
Patient has other diseases	3
Patients request	6
Patients’ worry	6

Table V. Physicians’ attitudes towards PSA-test.

Consider how well you agree with the following statements about PSA-test (range 1–7).
	Median	n
‘PSA-test’ subscale
*a good test	5	298
*provides good guidance	5	298
*good as an aid	5	301
*good test for detecting cancer	5	298
*a compliment to palpation	5	300
*an unreliable test	3	297
*an uncertain test	3	296
*a useless test	1	297
‘PSA-test as a sufficient screening tool’ subscale
*ought to be used for prevention	4	301
*I am in favor of general PSA screening	2	303
*should be included in routine health check-ups	2	303

Table VI. Factors predicting physicians’ intention to ordinate PSA-test for men within different age groups.

Factors	R^2	ß	SE(ß)	t
Intention to refer men < 40	0.14
• PSA-test as a sufficient screening tool		0.38	0.02	6.04***
Intention to refer men 40–50	0.30
• PSA-test as a sufficient screening tool • Patients’ worry and request		0.52 0.13	0.02 0.03	8.88*** 2.19*
Intention to refer men 50–60	0.36
• PSA-test as a sufficient screening tool • Patients, worry and request		0.52 0.23	0.03 0.04	9.33*** 4.16***
Intention to refer men 60–70	0.40
• PSA-test as a sufficient screening tool • Patients’ worry and request • Physical symptoms		0.54 0.19 0.13	0.03 0.04 0.02	9.96*** 3.27** 2.24*
Intention to refer men > 70	0.38
• PSA-test as a sufficient screening tool • Physical symptoms		0.56 0.19	0.03 0.04	10.28*** 3.49**

*** = p < 0.000, ** = p < 0.001, *p < 0.05