Questionnaire. 1) Do you see men over the age of 40? 1. Yes 2. No

Transcription

1 Questionnaire 1) Do you see men over the age of 40? 1. Yes 2. No 2) In what state do you practice? (drop-down menu of 50 states and District of Columbia) 3) What is your medical specialty? (Please select all that apply) 1. Internal Medicine 2. Family Medicine 3. Other 4) How would you describe your practice environment? 1. Urban (city population of > 100,000) 2. Suburban (in the greater metropolitan area of an incorporated city) 3. Rural (area with population < 2500) 4. Other 5) Please indicate the type of your practice that best describes the primary location where you see patients. 1. Academic (university-based) 2. Integrated Health maintenance organization (e.g. Kaiser Permanente) 3. Hospital-based (non-academic) 4. Private practice small (1-5 clinicians) 5. Private practice - medium (5-20 clinicians) 6. Private practice - large (>20 clinicians) 7. Veterans Affairs Medical Center or military hospital 8. Publicly funded or non-profit community clinic 9. Other 6) What year did you finish residency? (drop-down menu from ) 7) Please indicate the percentage of patients in your practice that belong to the following racial/ethnic groups. (sum must equal 100) 1. African-American, Non-Hispanic 2. African-American, Hispanic 3. Caucasian, Non-Hispanic 4. Caucasian, Hispanic 5. Asian 6. Pacific Islander 7. Native American/Alaskan Native 8) Which of the following means of health care payment are most utilized by your patients? (please select up to 3 answer choices) 1. Self-pay 2. Private health insurance 3. Integrated health maintenance organization (e.g. Kaiser Permanente) 4. Veterans Affairs 5. Medicare 6. Medicaid 7. Uninsured 8. Other

2 9) How many patients with a history of prostate cancer do you see per month? 1. More than 5 every month every month 3. One every month (>12 patients per year) 4. One every two months (6-11 patients per year) 5. One every 3-6 months (2-5 patients per year) 6. One every 12 months (1 patient per year) 7. Fewer than one patient per year 10) In the last five years, have any of your immediate family member(s) or close friend(s) been diagnosed with prostate cancer? 1. Yes 2. No 11) Have any of these men died from prostate cancer? 1. Yes 2. No 12) What statement best describes your beliefs about PSA screening for prostate cancer in 50 to 70 year-old men? 1. The benefits of PSA screening generally outweigh the limitations, and I usually recommend it to my patients 2. There are benefits and limitations to PSA screening, and deciding whether or not to recommend screening is best approached on a case-by-case basis 3. The limitations of PSA screening generally outweigh the benefits and I usually recommend against it for my patients 13) For what percentage of male patients between the ages of 50 and 75 do you discuss the pros and cons of PSA testing before you order it for the first time? 1. <5% % % % 5. >75% 14) For what percentage of male patients between the ages of 50 and 75 do you order PSA as a prostate cancer screening test? 1. <5% % % % 5. >75% 15) At what age do you start PSA screening? (Please leave blank if you do not screen with PSA) 16) At what age do you end PSA screening? (Please leave blank if you do not screen with PSA)

3 17) Please indicate to what degree you disagree or agree with the following statements about PSA screening? PSA screening is accurate for detecting prostate Strongly Disagree Disagree Undecided Agree Strongly Agree cancer risks and benefits of PSA screening PSA screening extends patients lives Prostate cancer is over-diagnosed Prostate cancer is over-treated I have enough time in a routine visit to discuss the 18) Which factors most influence your decision to order PSA to screen men for prostate cancer? (Please select top three choices) 1. Patient age 2. Patient race/ethnicity 3. Patient life expectancy 4. Patient family history of prostate cancer 5. Patient request or expectation 6. Practice pattern in my community 7. My training 8. Concern for liability if I dont order the test 9. Evidence supporting efficacy of PSA screening in decreasing prostate cancer-specific mortality 10. My belief that the benefits of PSA screening outweigh the limitations for most men 11. Other 19) For which patient(s) would you recommend against PSA screening? (Please select all that apply) 1. Men which two or more medical co-morbidities (e.g. diabetes, coronary artery disease, hypertension) 2. Men with poor functional status 3. Men with a life expectancy less than 10 years 4. Men with a prior negative prostate biopsy 5. Healthy men over the age of Healthy men between the age of Healthy men between the age of Healthy men between the age of ) Do you offer a 5-alpha reductase inhibitor (finasteride/proscar or dutasteride/avodart) as a means of decreasing the likelihood of prostate cancer diagnosis? (Please select all that apply) 1. Yes, routinely 2. Yes, for those men with a prior negative prostate biopsy 3. Yes, if the patient has a strong family history 4. Yes, if the patients asks 5. No, I havent given much thought to offering finasteride as preventive therapy 6. No, it is not yet part of the standard of care for prostate cancer prevention 7. No, finasteride increases the risk of high-risk prostate cancer 8. No, the cost and risks of finasteride outweigh the benefits 9. No, finasteride does not decrease the risk of prostate cander2 21) Which of the following are known to increase prostate cancer risk? (Please select all that apply) 1. History of STDs 2. History of smoking 3. African-American race 4. History of BPH 5. Father who developed prostate cancer before the age of 60

4 6. Asian race 7. Past history of vasectomy 22) Which professional organization s guidelines most influence your practice of PSA screening? 1. American Cancer Society 2. United State Preventive Services Task Force 3. American College of Preventive Medicine 4. American Urological Association 5. National Comprehensive Cancer Network 6. Practice guidelines do not influence my practice of PSA screening 7. Other 23) To what degree are you familiar with the prostate cancer screening guidelines from the following organizations? American Cancer Society (2010) National Comprehensive Cancer Network (2007) United State Preventive Services Task Force (2008) American Urological Association (2009) American College of Preventive Medicine (2008) Not at all familiar Somewhat familiar Very familiar 24) What is your degree of familiarity with the results regarding prostate cancer screening from the Prostate, Lung, Colorectal and Ovarian trial (PLCO; Andriole et al., NEJM 2009) 1. I have critically read the article and subsequent commentary and understand the strengths and weaknesses of the study 2. I have read the study and understand the data on which the conclusions were based 3. I am familiar with the study outcomes referenced in academic journals 4. I am familiar with the study outcomes as reported by the lay press 5. I am aware of this study, but do not know the results 6. I am not aware of the study 25) What is your degree of familiarity with the results regarding prostate cancer screening from the European Randomized Study of Screening for Prostate Cancer (ERSPC; Schroder et al., NEJM 2009)? 1. I have critically read the article and subsequent commentary and understand the strengths and weaknesses of the study 2. I have read the study and understand the data on which the conclusions were based 3. I am familiar with the study outcomes referenced in academic journals 4. I am familiar with the study outcomes as reported by the lay press 5. I am aware of this study, but do not know the results 6. I am not aware of the study 26) What is your degree of familiarity with the results for finasteride and the primary prevention of prostate cancer from the Prostate Cancer Prevention Trial (PCPT; Thompson et al., NEJM 2004)? 1. I have critically read the article and subsequent commentary and understand the strengths and weaknesses of the study 2. I have read the study and understand the data on which the conclusions were based 3. I am familiar with the study outcomes referenced in academic journals 4. I am familiar with the study outcomes as reported by the lay press 5. I am aware of this study, but do not know the results 6. I am not aware of the study

5 27) Please indicate the degree to which each study has influenced your PSA screening practices? Prostate, Lung, Colorectal and Ovarian (PLCO) European Randomized Study of Screening for Prostate Not at all influential Neutral Somewhat influential Very influential Cancer (ERSPC) Prostate Cancer Prevention Trial (PCPT) 28) How has the how the most influential trial you indicated above changed your PSA screening practices? 1. I am now more likely to offer PSA screening 2. I am now less likely to offer PSA screening 3. I am no more or less likely to offer screening but I have greater confidence in my recommendations regarding screening 4. The referenced trials have not influenced my PSA screening practices 29) Please indicate to what degree you agree with the following statements. I am confident in my: Knowledge of prostate cancer risk factors Strongly Disagree Disagree Undecided Agree Strongly Agree screening of PSA screening Knowledge of how frequently PSA should be ordered Knowledge of what age PSA screening should begin Knowledge of when to refer a patient to a urologist Ability to answer patients questions about PSA Ability to communicate the benefits and limitations 30) What guides your decision to refer a patient to a urologist for evaluation for prostate caner? (Please select all that apply) 1. PSA >4ng/ml 2. Palpable prostate nodule on digital rectal examination 3. Increase in PSA greater than 0.75ng/ml/year 4. Informal consultation with a urologist 5. PSA value greater than age-related range 6. Free PSA less than 25% of total PSA value 7. Patient with PSA 3ng/ml with other known prostate cancer risk factor 8. Patient desire for referral 9. Other 31) Please indicate your gender 1. Male 2. Female 32) Please provide your age:

6 33) Please indicate your ethnicity 1. Hispanic 2. Not-Hispanic 34) Please indicate your race (please select all that apply). 1. African-American 2. Caucasian 3. Asian 4. Pacific Islander 5. Native American/Alaskan Native 6. Other Knowledge score calculated from questions 21, Confidence score calculated from question 29 Propensity to screen score calculated from questions 12-17