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

Objective:

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.

Methods:

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.

Results:

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.

Conclusions:

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.