MP39-14 IMPACT OF THE 2012 UNITED STATES PREVENTIVE SERVICES TASK FORCE RECOMMENDATION AGAINST PROSTATE SPECIFIC ANTIGEN SCREENING ON PROSTATE CANCER RISK GROUP STRATIFICATION

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening V1 Apr 2016MP39-14 IMPACT OF THE 2012 UNITED STATES PREVENTIVE SERVICES TASK FORCE RECOMMENDATION AGAINST PROSTATE SPECIFIC ANTIGEN SCREENING ON PROSTATE CANCER RISK GROUP STRATIFICATION Deepansh Dalela, Bjorn Loeppenberg, Akshay Sood, Jesse Sammon, Patrick Karabon, Maxine Sun, Quoc-Dien Trinh, Wooju Jeong, James Peabody, Mani Menon, and Firas Abdollah Deepansh DalelaDeepansh Dalela More articles by this author , Bjorn LoeppenbergBjorn Loeppenberg More articles by this author , Akshay SoodAkshay Sood More articles by this author , Jesse SammonJesse Sammon More articles by this author , Patrick KarabonPatrick Karabon More articles by this author , Maxine SunMaxine Sun More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , Wooju JeongWooju Jeong More articles by this author , James PeabodyJames Peabody More articles by this author , Mani MenonMani Menon More articles by this author , and Firas AbdollahFiras Abdollah More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.139AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The United States Preventive Services Task Force (USPSTF) in 2012 recommended against prostate specific antigen (PSA) screening in all men, regardless of age or ethnicity. We examined the changes in prostate cancer (PCa) stage at diagnosis before and after the USPSTF recommendation. METHODS 198708 new cases of PCa within the National Cancer Database (NCDB) 2011 and 2013 were extracted and risk-stratified according to the National Comprehensive Cancer Network guidelines (low: T1c-T2a, biopsy Gleason <=6 and PSA<10 ng/ml; intermediate: T2b-T2c, biopsy Gleason=7 or PSA 10-20 ng/ml; high: T3a and above, biopsy Gleason 8-10 or PSA >20 ng/ml). Logistic regression models were fitted to test the association between year of diagnosis and likelihood of low, intermediate and high-risk disease, adjusting for all available socio-demographic covariates (age, ethnicity, marital status, Charlson comorbidity index, hospital region, urban/rural residence, insurance, median income and education of the ZIP code, and hospital type) RESULTS Overall, the proportion of low risk cases decreased (31.9% vs. 25.9%), while intermediate (43.5% vs. 45.1%) and high risk (24.5% vs. 29.0%) cases increased from NCDB 2011 to 2013 (all p<0.001). Patients diagnosed in 2013 had higher PSA (>20 ng/ml: 13.9% vs. 11.5%), biopsy Gleason (8-10: 21.2% vs. 17.0%) and stage (>=cT3a: 4.8% vs. 4.0%) compared to 2011 (all p<0.01). On regression analyses, men diagnosed in 2013 vs. 2011 were less likely to be low risk (odds ratio [OR] 0.74), and more likely to be intermediate (OR 1.05) and high risk (OR 1.22; all p<0.01). CONCLUSIONS The USPSTF statement against PSA screening seems to have resulted in increased proportion of intermediate and high risk PCa at diagnosis. Future analyses may help ascertain the presence and degree of this ‘reverse’ stage migration for PCa. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e546-e547 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Deepansh Dalela More articles by this author Bjorn Loeppenberg More articles by this author Akshay Sood More articles by this author Jesse Sammon More articles by this author Patrick Karabon More articles by this author Maxine Sun More articles by this author Quoc-Dien Trinh More articles by this author Wooju Jeong More articles by this author James Peabody More articles by this author Mani Menon More articles by this author Firas Abdollah More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...