Effect of Uniform Consensus Recommendations for PCa Screening in Older Population: Differential Effects and Perceptions of Healthcare Providers and Patients

ObjectivesTo develop and distribute consensus recommendations to encourage a uniform approach to screening for prostate cancer (PCa) in men >75 years old. We also surveyed healthcare providers and men >75 years old to determine whether provider attitudes toward continued PCa screening in older men had changed.MethodsWe mailed surveys to 2809 Iowa providers to assess their practice toward PCa screening and adoption of the consensus recommendations. The results were compared with those from a preintervention survey. We also surveyed 9000 Iowa men >75 years old to determine whether their providers had changed their screening methods.ResultsA total of 614 providers (29%) and 1650 men (18%) >75 years old responded. Only 48% of providers intended to screen men >75 years old, which was reduced from the 63% reported in the preintervention survey. Of the 31% of providers who had knowledge of the consensus recommendations, 72% indicated they had adopted, or intended to adopt, the recommendations. Of the men >75 years old, 84% had undergone a prostate-specific antigen test during their life, and 75% had continued to be screened after 75 years of age. Also, 54% indicated that their provider had discussed screening when they turned 75. Only 18% noted a change in their physician's approach to PCa screening after the consensus recommendations had been released.ConclusionsProvider-based education can assist in formulating a thoughtful approach to screening and treatment of older men. A combination of patient- and provider-directed education could help to encourage focused and appropriate PCa screening in older men.