Shared Decision Making in Prostate-Specific Antigen Testing With Men Older Than 70 Years

Jun Li; Zahava Berkowitz; Thomas B. Richards; Lisa C. Richardson

doi:10.3122/jabfm.2013.04.120267

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Figure 1.
Age-specific prevalence and 95% confidence intervals of prostate-specific antigen screening within the past year, by year (2005 and 2010) of the National Health Interview Survey.

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Table 1. Unadjusted Associations Between Prostate-Specific Antigen Screening and Sociodemographic and Screening-Related Factors Among Men Aged 70 Years or Older, National Health Interview Survey 2010

	N^*	Percentage^{^†}	95% Confidence Interval	P^{^‡}
Total	1045	44.1	40.5–47.8
Age, years				.02
70–74	396	49.0	43.0–55.0	Reference
75–79	304	45.0	38.2–52.1	.400
≥80	345	37.0	31.4–43.0	.006
Race/ethnicity				<.001
Non-Hispanic white	727	47.0	42.9–51.1	Reference
Non-Hispanic black	144	32.7	24.4–42.3	.004
Non-Hispanic other	66	27.4	16.7–41.4	.011
Hispanic	108	30.1	20.7–41.6	.003
Education				<.001
Less than high school	306	32.1	25.5–39.4	Reference
High school graduate	308	40.1	34.2–46.3	.096
Some college	202	47.3	39.7–54.9	.003
College graduate	223	59.0	51.0–66.6	<.001
Marital status				<0.001
Married or living with partner	589	49.3	44.8–53.8	Reference
Widowed, divorced, or separated	400	30.2	25.2–35.7	<.001
Never married	55	39.8	27.1–54.2	.206
Usual source of medical care				<.001
Yes	998	45.5	41.8–49.3	Reference
No	47	11.1	4.38–25.5^{^§}	<.001
Family history of prostate cancer				.092
Yes	78	53.7	42.4–64.6	Reference
No	915	43.4	39.5–47.4	.091
Comorbidity				.115
None	229	37.8	30.9–45.2	Reference
1 disease	336	47.0	41.1–52.9	.045
2 diseases	278	42.4	35.6–49.4	.385
≥3 diseases	202	48.5	40.4–56.6	.049
Had any cancers excluding prostate cancer?				.018
Yes	182	52.9	44.8–60.9	Reference
No	863	42.0	38.0–46.2	.018
Discussed scientific uncertainties				<.001
Yes	138	63.2	53.9–71.6	Reference
No	874	40.8	36.9–44.8	<.001
Discussed advantages/disadvantages				<.001
None	606	31.4	26.9–36.3	Reference
Advantages only	197	60.0	51.7–67.8	<.001
Disadvantages only^{^‖}	—	—	—	—
Both	185	62.6	54.6–70.0	<.001

↵* Number may differ from totals because of “don't know,” refused, or missing responses.
↵† Percentage of population estimates adjusted for National Health Interview Survey sampling design.
↵‡ χ² Test when the P value is located on a row of a main effect. P values for a general linear contrast comparing a row's percentage to its reference level are located on the level (category) within the main effect.
↵§ Percentages should be interpreted with caution because the relative standard error is >30%.
↵‖ Count and unadjusted percentage are not shown because there are <30.

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Table 2. Adjusted Associations Between Prostate-Specific Antigen Screening and Sociodemographic and Screening-Related Factors Among Men Aged 70 Years or Older, National Health Interview Survey 2010

	Percentage^*	95% Confidence Interval	P^{^†}
Total	44.0	40.2–47.8
Age, years			.086
70–74	47.3	41.0–53.7	Reference
75–79	45.5	38.8–52.4	.705
≥80	37.9	32.1–44.1	.036
Race/ethnicity			.052
Non-Hispanic white	45.6	41.3–49.9	Reference
Non-Hispanic black	36.3	26.8–47.0	.910
Non-Hispanic other	31.5	20.2–45.6	.562
Hispanic	37.1	27.7–47.6	.098
Education			.131
Less than high school	38.8	31.5–46.7	Reference
High school graduate	41.1	35.1–47.5	.650
Some college	44.8	37.6–52.3	.255
College graduate	51.1	42.9–59.2	.030
Marital status			.001
Married or living with partner	47.4	42.9–51.9	Reference
Widowed, divorced, or separated	34.7	29.0–40.8	<.001
Never married	36.5	22.9–52.7	.177
Usual source of medical care^{^‡}			.062
Yes	44.4	40.6–48.3	Reference
No	22.6	9.1–46.1	.025
Family history of prostate cancer			.243
Yes	49.8	39.5–60.0	Reference
No	43.3	39.3–47.3	.245
Comorbidity			.167
None	38.9	32.0–46.4	Reference
1 disease	46.8	41.3–52.5	.069
2 diseases	41.1	34.0–48.6	.679
≥3 diseases	47.9	39.9–55.9	.095
Had any cancers excluding prostate cancer?			.284
Yes	47.8	39.6–56.1	Reference
No	42.9	38.8–47.1	.285
Discussed scientific uncertainties			.102
Yes	51.8	40.9–62.6	Reference
No	42.3	38.4–46.3	.106
Discussed advantages/disadvantages			<.001
None	34.3	29.2–39.9	Reference
Advantages only	57.4	48.9–65.4	<.001
Disadvantages only^{^‡}	24.1	5.0–65.5	.545
Both	55.9	46.9–64.6	<.001

↵* Percentages of the population estimates were adjusted for the National Health Interview Survey sampling design.
↵† Wald χ² test when the P value is located on a row of a main effect. P values for a general linear contrast comparing a row's percentage to its reference level are located on the level (category) within the main effect using t test statistics.
↵‡ Percentages should be interpreted with caution because the relative standard error is >30%.