To screen or not to screen, when clinical guidelines disagree: primary care physicians' use of the PSA test.

Abstract:

BACKGROUND:Clinical guidelines for using the prostate-specific antigen (PSA) test as a population-based screening tool vary considerably. This study qualitatively explored primary care physicians' PSA screening practices and their understanding of the PSA screening controversy. METHODS:Fourteen telephone focus groups were conducted with 75 primary care physicians practicing in 35 US states. Data were coded around three major topics: PSA screening practices, factors influencing these practices, and familiarity with clinical guidelines. RESULTS:Two practice patterns emerged. Most participants recommended regular PSA screening beginning around age 50 for asymptomatic men with no known risk factors and at least a 10-year life expectancy. These "routine screeners" attributed their approach to experience that supported the benefit of PSA screening and to patient demand for the test. Other physicians discussed the implications of PSA screening with patients before offering the test, but neither recommended for or against it. The approach of these "nonroutine screeners" was primarily guided by the lack of scientific evidence documenting the benefit of PSA screening. CONCLUSIONS:The observed practice patterns reflect both sides of the PSA screening controversy. While routine and nonroutine screeners differ in their approach, both reported high rates of PSA screening.

journal_name

Prev Med

journal_title

Preventive medicine

authors

Purvis Cooper C,Merritt TL,Ross LE,John LV,Jorgensen CM

doi

10.1016/j.ypmed.2003.09.035

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

182-91

issue

2

eissn

0091-7435

issn

1096-0260

pii

S0091743503002408

journal_volume

38

pub_type

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