Abstract: PD40-11
Sources of Funding: None

Introduction

We examined the association of primary care physician (PCP) length of practice and prostate specific antigen (PSA) screening opinions on the differential effect of the United States Preventative Services Task Force (USPSTF) recommendation against PSA screening in 2012.

Methods

54,684 resulted PSA orders at our institution were reviewed from 2010-2015. Tests were excluded if they were performed by a non-PCP, if the provider ordered <4 tests/year, had a practice break >6 months, or if the provider was not employed at the institution for the entire period. Relative proportions of PSA orders per overall unique male ambulatory clinic volume were assessed for 2010-2011 (first period) and 2013-2015 (second period). Changes on a per-provider basis were assessed as a scatterplot, linear regression, and ANOVA. PCPs were surveyed on their attitudes towards the USPSTF recommendation and responses compared to physician seniority and actual PSA ordering habits.

Results

228,731 unique male non-oncology care patients were assessed. From an initial cohort of 88 PCPs, 22 PCPs met inclusion criteria. Mean time between completion of residency and beginning of period was 16 years (range 2-43). There was a significant inverse relationship (Fig 1) between years since completion of residency and change in the overall proportion of patients who underwent PSA screening, with more senior physicians noted to have a larger relative decline in screening rates after the USPSTF recommendation (R2 = 0.308, p=0.007). Eighteen PCPs completed a survey on the USPSTF and PSA which revealed no correlation between stated attitudes toward PSA screening and observed practice, however senior PCPs were more likely to claim greater current PSA screening (p=0.037).

Conclusions

Greater time since residency completion was significantly associated with screening proportionally fewer men over the period. PCPs’ stated opinion on PSA screening did not appear to have a strong influence on actual observed practice.

Funding

None