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

Objectives: To 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. Methods: We 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. Results: A 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. Conclusions: Provider-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.