Are Men Making Informed Decisions According to the Prostate-Specific Antigen Test Guidelines? Analysis of the 2015 Behavioral Risk Factor Surveillance System

Abstract

The prostate-specific antigen (PSA) screening recommendation endorses the opportunity for men to make an informed decision about whether or not to screen. This entails speaking with a provider to discuss the potential advantages, disadvantages, and uncertainties about the PSA screening test. The purpose of this study was to examine (a) the reported level of being informed about the PSA test by race and (b) the association between the receipt of the PSA test and participants reporting that they were informed about the test. U.S. adult males (ages 40–74 years) were identified from the 2015 Behavioral Risk Factors Surveillance System (BRFSS; n = 3,877). Chi-square analysis assessed bivariate differences among men who received different levels of PSA screening information. Binomial logistic regression models assessed the relationship of race/ethnicity and the receipt of the PSA test on being informed about the PSA test. Over half (54.3%) of the sample had a PSA test and most (72.0%) reported that they did not receive information about both the advantages and disadvantages (being informed) of the PSA test. Black men (40.3%) were significantly most likely to report being informed ( p < .001), and 61.3% reported receipt of a recommendation from their provider ( p < .001). White men (63.1%) were significantly more likely to report receiving the PSA test. Findings indicate that more men reported receiving the PSA test than men who reported being informed about it. Future research and interventions should strive for men of all racial and ethnic backgrounds to be informed about the PSA test before making a decision.

Nonlinear Relationship Between Age and Likelihood of Undergoing Prostate-Specific Antigen Testing, and the Predictive Factors of Testing at Different Ages

“…People only discussed the disadvantages of testing or discussed neither advantages nor disadvantages of testing have lower odds of testing compared with people discussed both advantages and disadvantages. This is consistent with the research results of most articles ( Bowen et al, 2011 ; Cooper et al, 2019 ; Li et al, 2015 ; Nguyen et al, 2020). This indicated shared decision making should be increased, especially for people with high risk of PCa, to improve screening rate.…”

“…However, results were inconsistent. For general population, some researches concluded black men had higher rates and odds of screening than white men (Cooper et al, 2019;Li et al,2015), while some didn't find any significant differences (Bowen et al, 2011;Nguyen et al, 2020). For specific age groups, Sammon et al (2016) reported younger black males (45-59 years old) had higher rates of screening than non-Hispanic white men of a similar age.…”

“…The relationship between age (as a continuous variable) and screening probability has not been reported previously. Several studies have investigated the factors influencing the frequency of PSA testing (Bowen et al, 2011;Cooper et al, 2019;Kensler et al, 2020;Li et al, 2015;Nguyen et al, 2020;Sammon et al, 2016Sammon et al, , 2018Scosyrev et al, 2012), with most of them based on BRFSS data. However, these studies either investigated the influencing factors for the general population or a certain factor in different age groups.…”

Effect of a Prostate Cancer Screening Decision Aid for African-American Men in Primary Care Settings

“…In the 2011-2012 Health Information National Trends Survey, African-American men were less likely to report being engaged in SDM (40). In contrast, data from the 2015 Behavioral Risk Factor Surveillance Survey found that African-American men were more likely to have been informed about screening compared with White men (6). However, direct cross-comparison of these national surveys is complicated due to differences in aspects of SDM measured (e.g., having discussed screening vs. being informed of the pros and cons), differences in age groups of men included in the samples, and prior screening histories (e.g., never vs. ever vs. recent).…”

“…[3][4][5]. Despite this universal recommendation, data from the 2015 Behavioral Risk Factor Survey show that only a quarter (23%) of men who had undergone PSA testing within the past year had discussed the advantages and disadvantages of screening with their providers (6). There are many barriers to fully engaging patients in SDM, including the short duration of medical appointments and the need to prioritize a range of health concerns (7).…”