Login to Access Video or Poster Abstract: MP28-08
Sources of Funding: none

Introduction

Prostate-specific antigen (PSA)-based prostate cancer screening is a controversial practice. Most evidence point towards many individuals subjected to the test without discussion on the potential harms of overdiagnosis and overtreatment. However, little is known about the opposite phenomenon: patients offered the PSA test who refused.

Methods

We analyzed male participants from the 2001 to 2008 cycles of the National Health and Nutrition Examination Survey (NHANES) ?40 years, without a history of prostate cancer, recent prostate manipulation, or hormonal therapy use (n=6,032). All men were given an opportunity to undergo or refuse PSA testing after a standardized explanation about prostate cancer screening with a physician. A multivariate logistic regression was conducted after adjusting for survey weights to identify independent socio-demographic and clinical predictors for opting out of PSA testing.

Results

6,032 men met inclusion criteria. Overall, 95% of the study cohort elected to undergo PSA testing. The odds of declining PSA testing was significantly higher in men 80 years of age (OR: 1.74; p=0.01), men of Black race (OR: 2.53; p<0.001), divorced/separated men (OR: 1.58; p=0.048), men with less than a high school education (OR: 1.72; p=0.02), and men with a pre-existing non-prostate malignancy (OR: 2.67; p<0.001).

Conclusions

Between 2001 and 2008, the majority of men who were offered prostate cancer screening underwent PSA testing. Interestingly, Black men, a subgroup generally presenting with more aggressive prostate cancer, were more likely to refuse PSA testing.

Funding

none