Purpose: The aim of the current study was to investigate physician- and patient-related factors influence on primary care physicians’ decision to order a prostate specific antigen (PSA) test for asymptomatic men.

Methods: A total of 305 Swedish physicians filled out the study questionnaire containing items about physicians’ attitudes towards PSA-test and the probability of screening of healthy men of varying ages.

Results: The majority of physicians reported positive attitude towards PSA-testing. However, the likelihood of offering PSA-testing to young men was low, but increased with age. Patient suffering from another disease (s) was the only variable which increased the likelihood of ordering screening test in all age groups. This was followed by the level of the patients’ worry which was an indicator in age groups above 40 years. Physicians’ opinion about using PSA-test as a screening tool was the most important physician-related variable affecting physicians’ decision regardless of patient age, followed by the physicians’ attitudes towards the test which was the second most influential factor in age groups above 40 years.

Conclusion: The decision to screen for prostate cancer using the PSA-test is influenced by several factors and not only those having direct clinical indication for prostate disease. This may lead to unnecessarily treatment of some patients.