Factors Influencing Shared Decision Making Regarding Prostate Specific Antigen Screening among Providers and African American Men: Evidence from the 2010-2018 National Health Interview Surveys (NHIS)

Prostate cancer is the second leading cause of death in men. All men, especially African American men, face challenging decisions related to prostate cancer screening. Shared decision making and effective communication should be incorporated by physicians and other health care professionals as proposed by national health organizations. The purpose of this study was to examine the factors associated with patient-physician discussions regarding advantages, disadvantages, and scientific uncertainty for prostate-specific antigen screening. The 2010-2018 National Health Interview Surveys (NHIS) were analyzed. Univariate, bivariate, and multivariate logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). This study found that African American men who are older, have a higher level of education, a higher income status, married, have a family history of prostate cancer, and comorbid conditions were more likely to have doctors recommend PSA screening. Results also revealed that doctors were more likely to discuss the advantages, disadvantages, and the scientific uncertainty of PSA screening among African American men. Future research on multiple influences that affect PSA testing decisions should be considered top priorities for resource allocation in research, practice, and public health policy. INDEX WORDS: Prostate specific antigen, National health interview survey, Prostate cance