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Is Anyone Listening? Variation in PSA Screening among Providers for Men 75+ before and after United States Preventive Services Task Force Recommendations against It: A Retrospective Cohort Study

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  • James S Goodwin
  • Elizabeth Jaramillo
  • Liu Yang
  • Yong-Fang Kuo
  • Alai Tan

Abstract

Background: In 2008, the United States Preventive Services Task Force recommended against prostate specific antigen (PSA) testing for cancer screening in men age 75+. Purpose: To assess PSA screening by primary care physicians (PCPs) before and after recommendations. Methods: In 2013, this retrospective cohort study analyzed PCPs in Texas with 20+ male patients aged 75+ in both 2007 and 2010, with Parts A and B Medicare. The main outcome was percent of PCP’s male patients 75+ who received PSA testing ordered by the PCP in 2007 and 2010, with no recent symptoms suggestive of prostate cancer. Results: In both 2007 and 2010, 1,083 PCPs cared for at least 20 men aged 75 or older. The rate of PSA screening ordered by PCPs was 33.2% in 2007 and 30.6% in 2010. In multilevel analyses controlling for patient characteristics, the variation in PSA screening attributable to the PCP (intraclass correlation coefficient) increased from 23% in 2007 to 26% in 2010, p

Suggested Citation

  • James S Goodwin & Elizabeth Jaramillo & Liu Yang & Yong-Fang Kuo & Alai Tan, 2014. "Is Anyone Listening? Variation in PSA Screening among Providers for Men 75+ before and after United States Preventive Services Task Force Recommendations against It: A Retrospective Cohort Study," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-7, September.
    • Handle: RePEc:plo:pone00:0107352
    DOI: 10.1371/journal.pone.0107352
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    1. Carmen E. Guerra & Phyllis A. Gimotty & Judy A. Shea & José A. Pagán & J. Sanford Schwartz & Katrina Armstrong, 2008. "Effect of Guidelines on Primary Care Physician Use of PSA Screening: Results from the Community Tracking Study Physician Survey," Medical Decision Making, , vol. 28(5), pages 681-689, September.
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