OBJECTIVES : Little is known about the influence of shared decision making on prostate-specific antigen (PSA) receipt among men in the state of Florida. The purpose of the study is to examine the relationship between patient-provider communication and receipt of PSA after adjusting for individual factors, health access variables, and preventative behaviors.

METHODS : Data were drawn from the 2016 Florida Behavioral Risk Factor Surveillance System. Receipt of PSA testing among men aged between 40 and 69 years old and who had no history of prostate cancer was the primary outcome. Multiple logistic regression analyses were used to adjust for individual factors (age, race, marital status, education, employment status, comorbidity, health status) health access variables (insurance, presence of a personal doctor, delayed care due to cost) and lifestyle characteristics (smoking, heavy alcohol use, physical inactivity) when associating pre-screening discussions with PSA testing. The data was weighted to adjust for varying probabilities of selection and non-response. Discussions were classified into four mutually exclusive categories: discussions of advantages and disadvantages, only advantages, only disadvantages, and no discussion.

RESULTS : Our study consisted of a weighted total of 2,737,491 (n=5,790). Rates of patient-provider discussions varied among respondents. The most significant predictors included physician recommendation (Adjusted OR [AOR]= 14.895; p<.0001), discussions including advantages (AOR = 8.389; p<.0001), older age (60-64; AOR = 5.910; p<.0001), never smoking (AOR = 2.293; p<.0001), being retired (AOR = 1.945; p<.0001), having a personal doctor (AOR = 1.880; p<.0001).

CONCLUSIONS : Men who engaged in conversations with their physician and were given recommendations had a greater likelihood in PSA receipt than those who did not engage in conversations. Our findings suggest that PSA screening behaviors can be influenced by the content and context of communication. Developing a bill to create an Office of Men’s Health at Health & Human Services to encourage screening informed decisions is recommended.