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Table 5 Factors significantly associated with the propensity of GPs to testing asymptomatic men

From: Factors prompting PSA-testing of asymptomatic men in a country with no guidelines: a national survey of general practitioners

  

Yes

Total

Univariate

Multivariate

  

Num

%

Num

OR [95%CI]

OR [95%CI]

GP Characteristics

      

   Gender

Male

867

79.7

1,088

1.00

1.00

 

Female

408

79.1

516

0.96 [0.74,1.25]

1.49 [1.08,2.05]

      

p = 0.016

   Age group

< 50 years

604

74.3

813

1.00

1.00

 

≥ 50 years

660

85.1

776

1.97 [1.53,2.54]

1.71 [1.27,2.31]

      

p = 0.002

   Full-time principal

Yes

1,038

81.4

1,275

1.00

1.00

 

No

225

71.9

313

0.58 [0.44,0.78]

0.57 [0.41,0.81]

      

p = 0.006

   Length of Practice 1

≤ 10 years

235

70.6

333

1

1

 

11–20 years

366

75.9

482

1.32 [0.96,1.80]

1.45 [1.02,2.07]

 

21–30 years

406

85.5

475

2.45 [1.73,3.47]

2.39 [1.60,3.56]

 

≥ 30 years

248

86.1

288

2.59 [1.72,3.89]

2.51 [1.57,4.03]

      

p < 0.001

Special interest in:

      

   Research

No

1,251

80.2

1,559

1.00

1.00

 

Yes

24

53.3

45

0.28 [0.15,0.51]

0.39 [0.20,0.77]

      

p = 0.008

   Cancer detection

No

1,166

78.3

1,489

1.00

1.00

 

Yes

109

94.8

115

5.03 [2.19,11.55]

3.61 [1.48,8.85]

      

p = 0.001

Practice characteristics

      

   Occupational Health Assessments

No

342

72.6

471

1.00

1.00

 

Yes

907

82.6

1,068

1.79 [1.39,2.31]

1.68 [1.27,2.22]

      

p = 0.001

   Actively involved in GP teaching

No

865

82.5

1,049

1.00

1.00

 

Yes

392

73.4

534

0.59 [0.46,0.75]

0.61 [0.46,0.80]

      

p = 0.002

   Run'Well man' clinic/appointments

No

541

75.2

1,311

1.00

1.00

 

Yes

721

83.4

278

1.91 [1.31,2.77]

1.59 [1.06,2.39]

      

p = 0.064

   Have a policy on PSA testing

No

865

75.2

719

1.00

1.00

 

Yes

392

83.4

865

1.67 [1.31,2.13]

1.45 [1.11,1.90]

      

p = 0.007

Knowledge

      

   PPV PSA level

< 30%

472

71.6

659

1.00

1.00

 

Overestimated (> 30%)

743

84.5

879

2.16 [1.68,2.78]

2.02 [1.55,2.63]

      

p < 0.001

   PPV PSA&DRE

< 50%

310

69.8

444

1.00

1.00

 

Overestimated (> 50%)

912

83.0

1,099

2.11 [1.63,2.72]

2.06 [1.56,2.73]

      

p < 0.001

Clinical Practice

      

   Refer 55 yr man at PSA level

≤ 7 ng/ml

803

82.9

969

1.00

1.00

 

≥ 7 ng/ml

332

74.9

443

0.62 [0.47,0.81]

0.60 [0.45,0.81]

 

Lab reference range

129

73.7

175

0.58 [0.40,0.84]

0.61 [0.40,0.93]

      

p = 0.002

   Frequency of PSA testing: Annually or less

Yes

457

94.2

485

6.01 [4.01,9.01]

5.54 [3.64,8.45]

 

No

793

73.1

1,085

1.00

1.00

      

p < 0.001

   Perform other routine tests with PSA

No

764

85.6

893

1.00

1.00

 

Yes

505

71.6

705

2.35 [1.83,3.01]

1.97 [1.51,2.57]

      

p < 0.001

   Inform patient prior to testing

Frequently

1,193

81.9

1,457

1.00

1.00

 

Sometimes

69

68.3

101

0.48 [0.31,0.74]

0.53 [0.31,0.89]

 

Rarely/Never

9

27.3

33

0.08 [0.04,0.18]

0.09 [0.04,0.23]

      

p < 0.001

   Had an asymptomatic man diagnosed with PCa via

 

   PSA testing

No

338

64.4

525

1.00

1.00

 

Yes

923

87.0

1,061

3.70 [2.87,4.76]

3.31 [2.51,4.37]

      

p < 0.001

   Practice changed post PSA-detected PCa 2

No

265

78.6

337

1.00

1.00

 

Yes

558

91.5

610

2.92 [1.98,4.29]

2.78 [1.81,4.25]

      

p < 0.001

   Consider having a PSA test yourself 3

No

48

37.8

127

1.00

1.00

 

Yes

807

85.7

942

9.80 [6.56,14.65]

8.25 [5.26,12.93]

      

p < 0.001

  1. The multivariate model was fully adjusted for characteristics of the GP (age, gender, full-time principal, health board, whether they had qualifications in geriatric medicine, palliative care or occupational health, whether they trained in UK, whether they had a specialist interest in men's health, research, urological problems or cancer detection) and the practice (solo vs multi-doctor practice, percent of patients with private health insurance, percent of time performing Occupational Health Assessments, involvement in GP teaching, running a "well man" clinic, and having a practice policy on PSA testing).
  2. 1Length of time in practice was not adjusted for age because they were correlated.
  3. 2Among GPs who had an asymptomatic man diagnosed with prostate cancer via PSA testing (n = 1,061)
  4. 3Among male GPs (n = 1,088)
  5. PPV = Positive Predictive Value.
  6. PCa = Prostate Cancer
  7. DRE = Digital Rectal Exam