Clinician Factors Associated With Prostate-Specific Antigen Screening in Older Veterans With Limited Life Expectancy.

ABSTRACT: Despite guidelines recommending against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, PSA screening remains common.To identify clinician characteristics associated with PSA screening rates in older veterans stratified by life expectancy.Cross-sectional study of 826?286 veterans 65 years or older eligible for PSA screening who had VA laboratory tests performed in 2011 in the VA health care system.The primary outcome was the percentage of men with a screening PSA test in 2011. Limited life expectancy was defined as age of at least 85 years with Charlson comorbidity score of 1 or greater or age of at least 65 years with Charlson comorbidity score of 4 or greater. Primary predictors were clinician characteristics including degree-training level, specialty, age, and sex. We performed log-linear Poisson regression models for the association between each clinician characteristic and PSA screening stratified by patient life expectancy and adjusted for patient demographics and clinician clustering.In 2011, 466?017 (56%) of older veterans received PSA screening, including 39% of the 203?717 men with limited life expectancy. After adjusting for patient demographics, higher PSA screening rates in patients with limited life expectancy was associated with having a clinician who was an older man and was no longer in training. The PSA screening rates ranged from 27% for men with a physician trainee to 42% for men with an attending physician (P?

SUBMITTER: Tang VL 

PROVIDER: S-EPMC5362377 | biostudies-literature | 2016 May

REPOSITORIES: biostudies-literature