PD48-09 PROSTATE SPECIFIC ANTIGEN (PSA) SCREENING UTILIZATION HAS SIGNIFICANTLY DROPPED OVER THE LAST TWO DECADES, EVEN IN MEN WITH EXTENDED LIFE-EXPECTANCY: A NATIONWIDE ANALYSIS

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You have accessJournal of UrologyProstate Cancer: Detection & Screening V (PD48)1 Apr 2020PD48-09 PROSTATE SPECIFIC ANTIGEN (PSA) SCREENING UTILIZATION HAS SIGNIFICANTLY DROPPED OVER THE LAST TWO DECADES, EVEN IN MEN WITH EXTENDED LIFE-EXPECTANCY: A NATIONWIDE ANALYSIS Deepansh Dalela*, Jacob Keeley, Akshay Sood, Sohrab Arora, Marcus Jamil, Isaac Palma-Zamora, Chandler Bronkema, Nikola Rakic, Natalija Kovacevic, Wooju Jeong, Craig Rogers, Mani Menon, and Firas Abdollah Deepansh Dalela*Deepansh Dalela* More articles by this author , Jacob KeeleyJacob Keeley More articles by this author , Akshay SoodAkshay Sood More articles by this author , Sohrab AroraSohrab Arora More articles by this author , Marcus JamilMarcus Jamil More articles by this author , Isaac Palma-ZamoraIsaac Palma-Zamora More articles by this author , Chandler BronkemaChandler Bronkema More articles by this author , Nikola RakicNikola Rakic More articles by this author , Natalija KovacevicNatalija Kovacevic More articles by this author , Wooju JeongWooju Jeong More articles by this author , Craig RogersCraig Rogers 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/10.1097/JU.0000000000000942.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Estimation of life expectancy (LE) is central to assessing the relative benefit of PSA screening among men. While prior research has suggested high prevalence of PSA screening in men with limited LE, limited data exists regarding screening for those with extended LE (who are arguably more likely to benefit from screening). The aim of the current study was to assess temporal trends in screening in US men with limited vs extended LE using a nationally representative dataset. METHODS: Using data from the National Health Institution Survey (NHIS) 2000-2018, men aged >=40 without prior history of prostate cancer who underwent PSA testing in the last 12 months as a part of routine test were considered to have undergone PSA screening. We used the previously validated Schonberg index to assess LE (based on 11 risk factors derived from function, illnesses, behaviors and demographics). Men with score of >10 were considered to have limited LE (i.e. LE <10 years, or >50% risk of 10-year mortality), while those with score of <6 were considered to have extended LE (i.e. LE>15 years, of <50% risk of 15-year mortality). Temporal trends in PSA screening in either group were compared using weighted chi-square tests. RESULTS: Within the study population, a total of 16,132 (weighted n=16,895,262) men were estimated to have extended LE, while 11,861 (weighted n=10,491,734) were included in the limited LE group. There was no significant difference in PSA screening prevalence based on extended (39.8%) vs. limited LE (39.4%) groups (p=0.5). Prevalence of PSA screening decreased over the study duration (Figure 1), even amongst men with extended LE (55.9% in 2003 to 35.5% in 2018; p<0.001). CONCLUSIONS: Our results show an overall drop in the utilization of PSA screening over the last two decades, without a distinction based on LE. It is highly concerning that even in men with an extended LE (i.e. >15 years), only 1 in 3 receive PSA screening, especially given the increased benefit of PSA screening with longer survival, as reported by level-one-evidence. This may be related to difficulties in estimating and/or discussing LE prior to ordering PSA screening, or the ambivalence of national guidelines regarding efficacy of screening, or a combination of both. Source of Funding: HFHS © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e997-e998 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Deepansh Dalela* More articles by this author Jacob Keeley More articles by this author Akshay Sood More articles by this author Sohrab Arora More articles by this author Marcus Jamil More articles by this author Isaac Palma-Zamora More articles by this author Chandler Bronkema More articles by this author Nikola Rakic More articles by this author Natalija Kovacevic More articles by this author Wooju Jeong More articles by this author Craig Rogers More articles by this author Mani Menon More articles by this author Firas Abdollah More articles by this author Expand All Advertisement PDF downloadLoading ...