BACKGROUND: No studies have examined medical students' recommendation and use of 
prostate-specific antigen (PSA) testing and digital rectal exam (DRE) to screen 
for prostate cancer. We hypothesized that students' race and extent of training 
on these techniques would be associated with their administration of them.
METHODS: We analyzed multiinstitutional longitudinal data from a cohort of 2181 
medical students in the class of 2003. We queried students' health behavior, 
their knowledge of prostate cancer racial disparities, their frequency of 
performing a PSA test or a DRE on a man 50 years of age or older (senior year 
only), the perceived relevance of such services to their future practice, and 
their training on PSA and DRE. We examined predictors of students' administering 
PSA and DRE tests to patients during the senior year and changes in the 
predictors over time.
RESULTS: Respectively, 27% and 34% of students reported using the PSA and DRE 
"usually/always" during their senior year. Black students reported administering 
the PSA test more often than did students of other races, but race was not a 
significant predictor of PSA screening after controlling for personal healthy 
behavior. High perceived relevance to future practice and extensive training on 
PSA were most strongly associated with administration of PSA.
CONCLUSIONS: The association between healthy personal behavior and PSA 
administration confounded the association between race and PSA screening. These 
results may help explain differences in prostate cancer screening among 
physicians and help medical educators tailor their curricula on prostate cancer 
screening.