US men discussing prostate-specific antigen tests with a physician.

Purpose: Informed decision making is recommended for prostate cancer screening. I wanted to examine demographic and screening-related factors associated with men's discussion of the advantages and disadvantages of prostate-specific antigen (PSA) tests with their physicians.

Methods: I used data from 2,184 men aged 50 years and older who reported a screening prostate-specific antigen (PSA) test in the 2000 National Health Interview Survey cancer control supplement. The dependent variable was discussion of the advantages and disadvantages of the test before it was conducted.

Results: Sixty-three percent of tested men reported a discussion in relation to their most recent PSA test. Discussion was more common for African American men and those with a usual source of care, and when the physician initiated the testing.

Conclusions: Characteristics of the patient-physician relationship were more central to the discussion of risks and benefits than were patient attributes. Future research should examine what role practice setting and the physician-patient relationship play in a discussion of PSA testing and how to facilitate active involvement of patients in decision making.