PSA Testing Differs Among Primary Care Doctors, Urologists

When it comes to prostate-specific antigen (PSA) testing, a new study reports that urologists are far more likely than primary care doctors to do perform these prostate cancer screenings.

The test is simple. blood sample is taken and sent to a laboratory to check for levels of a protein produced by cells of the prostate gland.

After the U.S. Preventative Services Task force recommended against routinely screening all men in 2011, PSA testing declined overall. New research shows that the decline in number of men tested was sharper among primary care doctors than urologists.

PSA testing decreased from 36 percent to 16 percent at primary care physician visits between 2010 and 2012. Researchers found that the decline in PSA testing was much smaller in urologist visits, dropping from 39 percent to 34 percent.

This discrepancy may reflect different perceptions of the benefits of the test among doctors, according to a study published online in JAMA Internal Medicine.

This much larger decline in PSA testing among primary care doctors could also stem from conflicting prostate cancer screening guidelines and differences in patients’ demographics or expectations, the study authors suggested.

The research team used the National Ambulatory Medical Care Survey to examine PSA testing one year before and one year after the task force recommendations were issued.

The study involved nearly 1,200 preventive office visits made by men aged 50 to 74 who were not diagnosed with cancer or any other prostate condition. Primary care doctors were seen in 1,100 of these visits. The others were examined by a urologist, a doctor who specializes in the urinary tract.

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