Edlefsen K L, Mandelson M T, McIntosh M W, Andersen M R, Wagner E H, Urban N
University of Washington School of Medicine, Seattle, USA.
Am J Prev Med. 1999 Jul;17(1):87-90. doi: 10.1016/s0749-3797(99)00041-0.
Screening for prostate cancer with the prostate-specific antigen (PSA) test remains controversial. This controversy is reflected in a lack of consensus in the medical literature and among professional and policy organizations regarding routine screening by PSA. It is not known how physicians respond when recommendations from experts are inconsistent.
A questionnaire was mailed to 1369 primary care physicians in active practice in Washington State in 1994. Response rate to the survey was 63%. Chi-square tests and multivariate logistic regression analysis were used to examine the effects of physician characteristics on physicians' self report of use of the PSA test for screening asymptomatic male patients, aged 50 to 80, for prostate cancer.
Of the 714 physicians included in the analysis, 68% reported routine use of PSA. Use of PSA varied among physicians on the basis of practice setting, years since medical school graduation, and whether compensation was fee-for-service or salaried. Male physicians trained before 1974 and physicians receiving fee-for-service were significantly more likely than other physicians to recommend screening by PSA.
Results suggest that physicians' personal characteristics such as year of medical school graduation, gender, and mode of reimbursement are related to self-reported PSA use.
使用前列腺特异性抗原（PSA）检测筛查前列腺癌仍存在争议。这一争议体现在医学文献以及专业和政策组织在PSA常规筛查方面缺乏共识。尚不清楚当专家建议不一致时医生会作何反应。
1994年，向华盛顿州1369名在职初级保健医生邮寄了一份调查问卷。调查的回复率为63%。采用卡方检验和多因素逻辑回归分析来研究医生特征对医生自我报告使用PSA检测筛查50至80岁无症状男性患者前列腺癌情况的影响。
纳入分析的714名医生中，68%报告常规使用PSA。根据执业环境、自医学院毕业的年限以及薪酬是按服务收费还是薪水制，医生对PSA的使用情况有所不同。1974年前接受培训的男医生以及按服务收费的医生比其他医生更有可能推荐进行PSA筛查。
结果表明，医生的个人特征，如医学院毕业年份、性别和报销方式，与自我报告的PSA使用情况有关。
