Prostate Cancer Testing Following the USPSTF Recommendations

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Prostate Cancer Testing Following the USPSTF Recommendations

Abstract and Introduction

Abstract


Purpose: To assess changes of prostate-specific antigen (PSA) testing following recent US Preventive Services Task Force (USPSTF) prostate cancer screening recommendations using 2005 to 2013 National Health Interview Survey data.

Methods: We calculated the percentage of PSA testing among men ≥40 years by age group and age-adjusted race for each survey year. Differences between years were assessed with linear contrasts after combining all years' data.

Results: The overall percentage of PSA testing was highest in 2008 and decreased significantly in 2013. Compared with 2008, each age group had significantly lower screening percentages in 2013, especially men ≥75 years old (−14.0% points; P < .001). Both men aged 50 to 74 and men aged ≥75 had significantly lower percentages in 2013 than in 2010. For white and black men, the PSA testing percentages were highest in 2008 and decreased significantly in 2013. Only white men had a significantly lower percentage in 2013 than in 2010.

Conclusions: Significant declines in PSA testing from 2008 to 2013 in men ≥75 years old may reflect the impact of the 2008 USPSTF recommendations. While the cause of the decreases in PSA testing between 2010 and 2013 among men aged 50 to 74 years old and white men is unknown, the decreases may suggest the early effects of the 2012 recommendations.

Introduction


Prostate-specific antigen (PSA) testing for prostate cancer screening has been widely used in the United States in the past 3 decades. Because harms outweighed benefits, in 2012 the US Preventive Services Task Force (USPSTF) expanded its 2008 recommendation against PSA testing among men aged ≥75 years to include men of all ages. Translation of the USPSTF recommendations into practice has had to compete with different recommendations from many medical organizations (http://www.guideline.gov/). Men often receive messages about screening that differ from the USPSTF recommendations. Recent studies have shown conflicting results about the impact of the 2008 USPSTF recommendations on the pattern of PSA testing. We examined National Health Interview Survey (NHIS) data from 2005 to 2013 to assess patterns of PSA testing following recent USPSTF recommendations.

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