\- The investigators propose a clinical trial to evaluate the impact of annual shared decision making for PSA screening, supported by system-level enhancements to promote evidence-based care:
* Defined referral thresholds within the health maintenance reminder, aligned with clinical risk stratification per NCCN guidelines. * Enhanced clinical decision support (CDS) tools to reduce provider variation and ensure guideline-concordant screening and referral practices. * The goal is to reduce late-stage presentation without increasing overdiagnosis-ensuring that prostate cancer screening is both accessible and clinically effective.
Receive care within the BJC Health System
Have had at least one primary care physician appointment in the calendar year of PSA screening (primary care)
Be male
Not have a history of prostate cancer
None
Single group
Annual PSA Health Maintenance Reminder
Other interventionThe annual health maintenance reminder does not mandate PSA screening for eligible patients. Instead, it recommends that primary care providers (PCPs) initiate a shared decision-making discussion with their patients. As part of this conversation, patients will be informed of their individual risk factors-including race, family history, and germline mutations-and can then make an informed choice about whether to proceed with PSA screening.
Change in PSA screening completion rates in the BJC East Health System
The overall PSA screening rate will be calculated as the number of PSA screening tests that are ordered by PCPs who will receive the alert and completed by patients within a year of the ordering date, divided by the total number of eligible patients.
Proportion of men diagnosed with clinically significant prostate cancer (Gleason score ≥ 7)
Incidence of advanced and metastatic disease at diagnosis of prostate cancer
Incidence of early-stage prostate cancer
Stage distribution of prostate cancer diagnoses
Click on the lead sponsor to view all of their trials.
