Prostate-specific antigen for prostate cancer screening - Do physician characteristics affect its use?

Purpose: Screening for prostate cancer with the prostate-specific antigen ( PSA) test remains controversial. This controversy is reflected in a lack of consensus in the medical literature and among professional and policy orga nizations regarding routine screening by PSA. It is not known how physician s respond when recommendations from experts are inconsistent. Methods: A questionnaire was mailed to 1369 primary care physicians in acti ve practice in Washington State in 1994. Response rate to the survey was 63 %. Chi-square tests and multivariate logistic regression analysis were used to examine the effects of physician characteristics on physicians' self re port of use of the PSA test for screening asymptomatic male patients, aged 50 to 80, for prostate cancer. Results: Of the 714 physicians included in the analysis, 68% reported routi ne use of PSA. Use of PSA varied among physicians on the basis of practice setting, years since medical school graduation, and whether compensation wa s fee-for-service or salaried. Male physicians trained before 1974 and phys icians receiving fee-for-senice were significantly more likely than other p hysicians to recommend screening by PSA. Conclusions: Results suggest that physicians' personal characteristics such as year of medical school graduation, gender, and mode of reimbursement ar e related to self-reported PSA use.