Factors associated with men's use of prostate-specific antigen screening: evidence from Health Information National Trends Survey

Prev Med. 2005 Apr;40(4):461-8. doi: 10.1016/j.ypmed.2004.07.011.


Background: Rapid uptake of prostate-specific antigen (PSA) testing has occurred in the United States despite inconclusive evidence regarding mortality benefit.

Methods: We examined data (n=927) from the 2003 Health Information National Trends Survey to assess prevalence of self-reported PSA use and its association with patients' decision making.

Results: Over half (55.2%) the sample reported ever having had a PSA test. Men aged 65-74 (OR=2.53, 1.49-4.31), with some college (OR=2.41, 1.22-4.77) or college degrees (OR=5.01, 2.53-9.90) were more likely to have had PSA tests, while men without health insurance (OR=0.32, 0.12-0.88) or a usual source of care (OR=0.35, 0.22-0.54) were less likely. In a model including healthcare provider communication and information seeking, men who reported that providers involved them in decisions (OR=1.76, 1.02-3.03) and recommended PSA (OR=236.3, 70.5-791.4) were more likely to have had the tests. Men aged 65-74 (OR=2.30, 1.33-4.00), with college degrees (OR=2.91, 1.45-5.82), and greater information attention/seeking (OR=1.23, 1.07-1.40) were more likely to report PSA recommendations, while those without usual care were less likely (OR=0.37, 0.22-0.64). Men without usual care (OR=0.38, 0.20-0.71) and Hispanic men (OR=0.40, 0.19-0.85) were less likely to report that healthcare providers involved them in healthcare decisions.

Conclusions: Results emphasize the relevance of patient decision making and the importance of healthcare providers in PSA testing.

MeSH terms

  • Aged
  • Decision Making*
  • Educational Status
  • Health Surveys
  • Humans
  • Male
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Office Visits
  • Patient Acceptance of Health Care
  • Prostate-Specific Antigen / analysis*
  • Prostatic Neoplasms / diagnosis
  • Socioeconomic Factors
  • United States


  • Prostate-Specific Antigen