Online Program

Factors Predicting Receipt of Prostate Specific Antigen (PSA) testing: Evidence from the National Ambulatory Medical Care Survey (NAMCS) Data

Tuesday, November 3, 2015

Zaina Qureshi, PhD, MPH, MS, Dept. of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
Mohammad Rifat Haider, MBBS, MHE, MPS, Dept. of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
Ronnie Horner, PhD, Health Services Policy and Management, Arnold School of Public Health, University of South Caroilna, Columbia, SC
Charles Bennett, PhD, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC

Prostate cancer (PCa) claimed the lives of approximately 29,480 men in 2014 and American Cancer Society estimates the incidence of prostate cancer in 2015 to be 220,800. Screening using the prostate specific antigen (PSA) test remains critical to the early detection and management of PCa. Our objective was to study the factors affecting PSA testing in the US for the year 2010.


We used the most recent National Ambulatory Medical Care Survey (NAMCS) data available which was for the year 2010. The NAMCS data is a nationally representative annual survey of the provision and utilization of outpatient medical care services in the US. Main outcome measure was undergoing the PSA test. A logistic regression model was fit to determine if any variables were associated with having the PSA test done.


Our weighted study sample consisted of primarily White men (N=568,146,002) between the ages of 50-64 years (N=231,848,274) residing in urban areas (N=544,556,049) covered by private health insurance (N=328,904,965) who were not being seen by a primary care provider (N=381,639,557). Majority of the men had undergone a PSA test (N=646,376,032). Multivariate analysis reveals that 65-79 years of age (OR: 3.4), living in urban areas (OR: 1.58), being consulted for chronic problems (OR: 2.25) and preventive services (OR: 4.40), being seen by surgical specialty physicians (OR: 1.52), and had private insurance (OR: 1.40) increased the likelihood of the visit resulting in a PSA test.


Contrary to expected standard of practice of primary care physician (PCP) visits influencing PSA testing, our study showed that visiting with a surgeon increased the likelihood of PSA testing. Providing patients with the opportunity to be tested as early as possible during their visit with a PCP might aid in efficiently diagnosing PCa.

Learning Areas:

Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Assess the factors affecting prostate specific antigen (PSA) test among American men.

Keyword(s): Cancer Prevention and Screening, Cancer and Men’s Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student at the Department of Health Services Policy and Management at Arnold School of Public Health, University of South Carolina. I am a physician by training. I also got my master's degrees in Health Economics and Population Sciences. My current research interest includes health services research, health economics and outcomes research (HEOR). I am currently working on research projects on patient-centered cancer care, and healthcare efficiency study in Papua New Guinea.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.