Primary Care Providers’ Intended Use of Decision Aids for Prostate-Specific Antigen Testing for Prostate Cancer Screening

  • Sun Hee Rim
  • Ingrid J. Hall
  • Greta M. Massetti
  • Cheryll C. Thomas
  • Jun Li
  • Lisa C. Richardson


Decision aids are tools intended to help people weigh the benefits and harms of a health decision. We examined primary care providers’ perspective on use of decision aids and explored whether providers’ beliefs and interest in use of a decision aid was associated with offering the prostate-specific antigen (PSA) test for early detection of prostate cancer. Data were obtained from 2016 DocStyles, an annual, web-based survey of U.S. healthcare professionals including primary care physicians (n = 1003) and nurse practitioners (n = 253). We found that the majority of primary care providers reported not using (patient) decision aids for prostate cancer screening, but were interested in learning about and incorporating these tools in their practice. Given the potential of decision aids to guide in informed decision-making, there is an opportunity for evaluating existing decision aids for prostate cancer screening for clinical use.


Prostate cancer Prostate specific antigen Decision aids Prostate cancer screening 



All authors are federal government employees, and the preparation of the manuscript was entirely funded by the U.S. government.

Compliance with Ethical Standards

Conflict of Interest

The authors declare they have no conflict of interest.


The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


  1. 1.
    Moyer VA (2012) Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 157(2):120–134CrossRefPubMedGoogle Scholar
  2. 2.
    Wolf AM, Wender RC, Etzioni RB, Thompson IM, D’Amico AV, Volk RJ, Brooks DD, Dash C, Guessous I, Andrews K, DeSantis C, Smith RA, American Cancer Society Prostate Cancer Advisory Committee (2010) American Cancer Society guideline for the early detection of prostate cancer: update 2010. CA Cancer J Clin 60(2):70–98CrossRefPubMedGoogle Scholar
  3. 3.
    Stacey D, Legare F, Col NF, Bennett CL, Barry MJ, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R et al:(2014)Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev (1):CD001431Google Scholar
  4. 4.
    Taylor KL, Williams RM, Davis K, Luta G, Penek S, Barry S, Kelly S, Tomko C, Schwartz M, Krist AH, Woolf SH, Fishman MB, Cole C, Miller E (2013) Decision making in prostate cancer screening using decision aids vs usual care: a randomized clinical trial. JAMA Intern Med 173(18):1704–1712PubMedPubMedCentralGoogle Scholar
  5. 5.
    Carlsson S, Leapman M, Carroll P, Schroder F, Albertsen PC, Ilic D, Barry M, Frosch DL, Vickers A (2015) Who and when should we screen for prostate cancer? Interviews with key opinion leaders. BMC Med 13:288CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Bornstein M, Ahmed F, Barrow R, Risley JF, Simmons S, Workowski KA (2017 Jan) Factors associated with primary care physician knowledge of the recommended regimen for treating gonorrhea. Sex Transm Dis 44(1):13–16CrossRefPubMedGoogle Scholar
  7. 7.
    Poghosyan L, Lucero R, Rauch L, Berkowitz B: Nurse practitioner workforce: a substantial supply of primary care providers. Nurs Econ 2012;30(5):268–274, 294Google Scholar
  8. 8.
    Martinez-Gonzalez NA, Djalali S, Tandjung R, Huber-Geismann F, Markun S, Wensing M et al (2014) Substitution of physicians by nurses in primary care: a systematic review and meta-analysis. BMC Health Serv Res 14:214CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Graubard BI, Korn EL (1999) Predictive margins with survey data. Biometrics 55(2):652–659CrossRefPubMedGoogle Scholar
  10. 10.
    Hall IJ, Rim SH, Massetti GM, Thomas CC, Li J, Richardson LC (2017) Prostate-specific antigen screening: an update of physician beliefs and practices. Prev Med 103:66–69CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Ilic D, Jammal W, Chiarelli P, Gardiner RA, Hughes S, Stefanovic D, Chambers SK (2015) Assessing the effectiveness of decision aids for decision making in prostate cancer testing: a systematic review. Psychooncology 24:1303–1315. CrossRefGoogle Scholar
  12. 12.
    Stamm AW, Banerji JS, Wolff EM, Slee A, Akapame S, Dahl K, Massman JD, Soung MC, Pittenger KR, Corman JM (2017) A decision aid versus shared decision making for prostate cancer screening: results of a randomized, controlled trial. Can J Urol 24(4):8910–8917PubMedGoogle Scholar
  13. 13.
    United States Preventive Services Task Force. Prostate cancer screening draft recommendations., Accessed date: 1 Nov 2017
  14. 14.
    Chou R, Dana T, Bougatsos C, Fu R, Blazina I, et al.: Treatments for localized prostate cancer: systematic review to update the 2002 U.S. Preventive Services Task Force Recommendation. Evidence Synthesis No. 91. AHRQ Publication No. 12–05161-EF-2. Rockville, MD: Agency for Healthcare Research and Quality; 2011Google Scholar
  15. 15.
    Carter HB, Albertsen PC, Barry MJ, Etzioni R, Freedland SJ, Greene KL, Holmberg L, Kantoff P, Konety BR, Murad MH, Penson DF, Zietman AL (2013) Early detection of prostate cancer: AUA guideline. J Urol 190(2):419–426CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Smith RA, Manassaram-Baptiste D, Brooks D, Cokkinides V, Doroshenk M, Saslow D, Wender RC, Brawley OW (2014) Cancer screening in the United States, 2014: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin 64(1):30–51CrossRefPubMedGoogle Scholar
  17. 17.
    Gutierrez JC, Terwiesch C, Pelak M, Pettit AR, Marcus SC (2015) Characterizing primary care visit activities at Veterans Health Administration clinics. J Healthc Manag 60(1):30–42CrossRefPubMedGoogle Scholar
  18. 18.
    Bruen BK, Ku L, Lu X, Shin P (2013 Sep) No evidence that primary care physicians offer less care to Medicaid, community health center, or uninsured patients. Health Aff (Millwood) 32(9):1624–1630. CrossRefGoogle Scholar
  19. 19.
    Herrmann A, Mansfield E, Hall AE, Sanson-Fisher R, Zdenkowski N (2016 Mar 15) Willfully out of sight? A literature review of the effectiveness of cancer-related decision aids and implementation strategies. BMC Med Inform Decis Mak 16:36CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Tasian GE, Cooperberg MR, Potter MB, Cowan JE, Greene KL, Carroll PR, Chan JM (2012) PSA screening: determinants of primary-care physician practice patterns. Prostate Cancer Prostatic Dis 15:189–194CrossRefPubMedGoogle Scholar
  21. 21.
    Kim HL, Benson DA, Stern SD, Gerber GS (2002) Practice trends in the management of prostate disease by family practice physicians and general internists: an internet-based survey. Urology 59:266–271CrossRefPubMedGoogle Scholar

Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2018

Authors and Affiliations

  • Sun Hee Rim
    • 1
  • Ingrid J. Hall
    • 1
  • Greta M. Massetti
    • 1
  • Cheryll C. Thomas
    • 1
  • Jun Li
    • 1
  • Lisa C. Richardson
    • 1
  1. 1.Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA

Personalised recommendations