National Prostate Cancer Screening Rates After the 2012 US Preventive Services Task Force Recommendation Discouraging Prostate-Specific Antigen-Based Screening

In 2012, the US Preventive Services Task Force (USPSTF) discouraged prostate-specific antigen (PSA) -based prostate cancer screening. Previous USPSTF recommendations did not appreciably alter prostate cancer screening. Therefore, we designed a trend analysis to determine the population-based impact...

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Vydané v:	Journal of clinical oncology Ročník 33; číslo 22; s. 2416 - 2423
Hlavní autori:	Drazer, Michael W, Huo, Dezheng, Eggener, Scott E
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States 01.08.2015
Predmet:	Adult Age Factors Aged Early Detection of Cancer - methods Early Detection of Cancer - standards Early Detection of Cancer - statistics & numerical data Early Detection of Cancer - trends Guideline Adherence - statistics & numerical data Guideline Adherence - trends Health Surveys Humans Interviews as Topic Life Expectancy Male Mass Screening - methods Mass Screening - standards Mass Screening - statistics & numerical data Mass Screening - trends Mental Recall Middle Aged Prostate-Specific Antigen - blood Prostatic Neoplasms - blood Prostatic Neoplasms - diagnosis Prostatic Neoplasms - mortality Research Design Risk Selection Bias United States - epidemiology United States
ISSN:	1527-7755
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Abstract	In 2012, the US Preventive Services Task Force (USPSTF) discouraged prostate-specific antigen (PSA) -based prostate cancer screening. Previous USPSTF recommendations did not appreciably alter prostate cancer screening. Therefore, we designed a trend analysis to determine the population-based impact of the 2012 recommendation. The nationally representative National Health Interview Survey was used to estimate the proportion of men age 40 years and older who saw a physician and were screened for prostate cancer in 2013. An externally validated 9-year mortality index was used to analyze screening rates based on remaining life expectancy. Screening rates from 2005, 2010, and 2013 were compared using logistic regression. PSA-based screening did not significantly change from 2010 to 2013 among 40- to 49-year-old men (from 12.5% to 11.2%; P = .4). Screening rates significantly declined in men age 50 to 59 years (from 33.2% to 24.8%; P < .01), age 60 to 74 years (from 51.2% to 43.6%; P < .01), and age 75 years or older (from 43.9% to 37.1%; P = .03). A large percentage of men were screened for prostate cancer despite a high risk (> 52%) of 9-year mortality, including approximately one third of men older than age 75 years. Approximately 1.4 million men age 65 years or older with a high risk (> 52%) of 9-year mortality were screened in 2013. Prostate cancer screening significantly declined among men older than age 50 years after the 2012 USPSTF guideline discouraging PSA-based screening. A significant proportion of men continue to be screened despite a high risk of 9-year mortality, including one third of men age 75 years and older.
AbstractList	PURPOSEIn 2012, the US Preventive Services Task Force (USPSTF) discouraged prostate-specific antigen (PSA) -based prostate cancer screening. Previous USPSTF recommendations did not appreciably alter prostate cancer screening. Therefore, we designed a trend analysis to determine the population-based impact of the 2012 recommendation.METHODSThe nationally representative National Health Interview Survey was used to estimate the proportion of men age 40 years and older who saw a physician and were screened for prostate cancer in 2013. An externally validated 9-year mortality index was used to analyze screening rates based on remaining life expectancy. Screening rates from 2005, 2010, and 2013 were compared using logistic regression.RESULTSPSA-based screening did not significantly change from 2010 to 2013 among 40- to 49-year-old men (from 12.5% to 11.2%; P = .4). Screening rates significantly declined in men age 50 to 59 years (from 33.2% to 24.8%; P < .01), age 60 to 74 years (from 51.2% to 43.6%; P < .01), and age 75 years or older (from 43.9% to 37.1%; P = .03). A large percentage of men were screened for prostate cancer despite a high risk (> 52%) of 9-year mortality, including approximately one third of men older than age 75 years. Approximately 1.4 million men age 65 years or older with a high risk (> 52%) of 9-year mortality were screened in 2013.CONCLUSIONProstate cancer screening significantly declined among men older than age 50 years after the 2012 USPSTF guideline discouraging PSA-based screening. A significant proportion of men continue to be screened despite a high risk of 9-year mortality, including one third of men age 75 years and older. In 2012, the US Preventive Services Task Force (USPSTF) discouraged prostate-specific antigen (PSA) -based prostate cancer screening. Previous USPSTF recommendations did not appreciably alter prostate cancer screening. Therefore, we designed a trend analysis to determine the population-based impact of the 2012 recommendation. The nationally representative National Health Interview Survey was used to estimate the proportion of men age 40 years and older who saw a physician and were screened for prostate cancer in 2013. An externally validated 9-year mortality index was used to analyze screening rates based on remaining life expectancy. Screening rates from 2005, 2010, and 2013 were compared using logistic regression. PSA-based screening did not significantly change from 2010 to 2013 among 40- to 49-year-old men (from 12.5% to 11.2%; P = .4). Screening rates significantly declined in men age 50 to 59 years (from 33.2% to 24.8%; P < .01), age 60 to 74 years (from 51.2% to 43.6%; P < .01), and age 75 years or older (from 43.9% to 37.1%; P = .03). A large percentage of men were screened for prostate cancer despite a high risk (> 52%) of 9-year mortality, including approximately one third of men older than age 75 years. Approximately 1.4 million men age 65 years or older with a high risk (> 52%) of 9-year mortality were screened in 2013. Prostate cancer screening significantly declined among men older than age 50 years after the 2012 USPSTF guideline discouraging PSA-based screening. A significant proportion of men continue to be screened despite a high risk of 9-year mortality, including one third of men age 75 years and older.
Author	Drazer, Michael W Huo, Dezheng Eggener, Scott E
Author_xml	– sequence: 1 givenname: Michael W surname: Drazer fullname: Drazer, Michael W organization: All authors: University of Chicago Medical Center, Chicago, IL – sequence: 2 givenname: Dezheng surname: Huo fullname: Huo, Dezheng organization: All authors: University of Chicago Medical Center, Chicago, IL – sequence: 3 givenname: Scott E surname: Eggener fullname: Eggener, Scott E email: seggener@surgery.bsd.uchicago.edu organization: All authors: University of Chicago Medical Center, Chicago, IL. seggener@surgery.bsd.uchicago.edu
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/26056181$$D View this record in MEDLINE/PubMed
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SubjectTerms	Adult Age Factors Aged Early Detection of Cancer - methods Early Detection of Cancer - standards Early Detection of Cancer - statistics & numerical data Early Detection of Cancer - trends Guideline Adherence - statistics & numerical data Guideline Adherence - trends Health Surveys Humans Interviews as Topic Life Expectancy Male Mass Screening - methods Mass Screening - standards Mass Screening - statistics & numerical data Mass Screening - trends Mental Recall Middle Aged Prostate-Specific Antigen - blood Prostatic Neoplasms - blood Prostatic Neoplasms - diagnosis Prostatic Neoplasms - mortality Research Design Risk Selection Bias United States - epidemiology
Title	National Prostate Cancer Screening Rates After the 2012 US Preventive Services Task Force Recommendation Discouraging Prostate-Specific Antigen-Based Screening
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