PD50-11 CHANGES IN PSA SCREENING RELATIVE TO THE REVISED USPSTF GUIDANCE FOR PROSTATE CANCER SCREENING

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening V (PD50)1 Sep 2021PD50-11 CHANGES IN PSA SCREENING RELATIVE TO THE REVISED USPSTF GUIDANCE FOR PROSTATE CANCER SCREENING Michael Leapman, Rong Wang, Cary Gross, and Xiaomei Ma Michael LeapmanMichael Leapman More articles by this author , Rong WangRong Wang More articles by this author , Cary GrossCary Gross More articles by this author , and Xiaomei MaXiaomei Ma More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002072.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In April 2017 the United States Preventive Services Task Force (USPSTF) published a draft guideline that reversed 2012 guidance against routine screening for prostate cancer, instead endorsing individual decision-making (a ‘Grade C’ recommendation) for men aged 55-69 but continued to discourage screening for patients >70 years. We estimated the effects of the guideline change on prostate specific antigen (PSA) testing practices in a large privately insured population in the U.S. METHODS: We accessed claims from Blue Cross Blue Shield, the largest private commercial insurance carrier, to evaluate trends in PSA testing among patients aged 40-89 years from January 1, 2013 through December 31, 2019 with continuous insurance for at least 12 months. We calculated crude and age-adjusted rates of PSA screening based on laboratory and procedure codes. We used interrupted time series analyses to evaluate the effects of the draft (April 2017) and published (May 2018) USPSTF guideline on rates of PSA testing. We further examined effects within the subset of age across commonly used cutoffs for screening identified in the guideline (40-54, 55-69, and 70-89 years). RESULTS: We identified a cohort of 17,553,527 eligible insurance beneficiaries. In the period preceding the 2017 statement, the PSA testing rate was 33.3 per 100 person-years (standard deviation, SD 1.24). Rates of testing increased following the publication of the draft guideline to 35.2 per 100 person-years (SD 1.60). Interrupted time series analysis revealed a significant increasing time trend in the post-draft period, across all age groups (p<0.01). The largest overall increases occurred among beneficiaries aged 50-69 years (from 50.0 to 54.1 per 100 person-years, p<0.001) in the periods before and after the guideline change, respectively. CONCLUSIONS: Rates of PSA testing increased following changes to the USPSTF’s draft statement in 2017, reversing trends seen following earlier guidance against PSA testing for all patients. Increases in testing among older patients may renew concerns about the clinical application of PSA testing to individuals less likely to benefit. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e856-e856 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Leapman More articles by this author Rong Wang More articles by this author Cary Gross More articles by this author Xiaomei Ma More articles by this author Expand All Advertisement Loading ...