Table 1

Responses to question about persuading a patient to be screened who refuses the PSA test.±*

Would try to persuade patient to have the PSA test

(n = 13)

Would not try to persuade patient to have the PSA test

(n = 45)


Belief in Early Detection

Patient Autonomy

"Because prostate cancer found early is curable."

"The patient is the ultimate decision maker."

"How else could you be diagnosed and treated?"

"The patient has the final say in his care."

"Patient has the right to refuse after the discussion of the benefit and risk of PSA screening."

Asymptomatic Presentation

Lack of Scientific Evidence

"Because prostate cancer could be asymptomatic."

"No good evidence that screening prevents morbidity & mortality."

"I have a number of asymptomatic patients with increased PSA. Therefore, prostate cancer."

Belief in Efficacy of the Test

Questionable Efficacy of Test

"Relatively low number false positives."

"The test is not specific enough to recommend without reservation in low risk people."

"Personally I believe in the benefit."

"Test has too many false positives."

Part of Routine Care

Time Constraints

"Usually doing other lab work – one more tube if positive then he can consider further evaluation if desired."

"Too time intensive."

Concerns about Side Effects

"The complications of biopsy and treatment might outweigh the benefit."


± Data from a university-based family medicine clinic and six community health centers in Houston, TX collected in February 2004.

*One response missing.

Linder et al. BMC Family Practice 2009 10:19   doi:10.1186/1471-2296-10-19

Open Data