Abstract
Purpose: Prostate cancer screening is a controversial topic. We examined trends in Prostate Specific Antigen (PSA) testing in an underserved population before and after the United States Preventative Services Task Force (USPSTF) recommendation against screening.Methods: Data were collected on all PSA and cholesterol screening tests from 2008 to 2014. We examined the trend of these tests and prostate biopsies while comparing this data to lipid panel data to adjust for changes in patient population.Results: A decrease in PSA screening was observed from 2010 through 2014, with the greatest decline in 2012. The age group most affected was patients aged 55–69 years. The amount of prostate biopsies during this period decreased as well.Conclusions: Decreased rates of PSA screening were observed in our urban hospital population that preceded the publication of the USPSTF guidelines. The incidence of prostate biopsies decreased in this timeframe. It now remains to be demonstrated whether decreased PSA screening rates impact the diagnosis of and ultimately the survival from prostate cancer.
Highlights
Prostate cancer is the second leading cause of cancerrelated death in men.[1]
We examined trends in Prostate Specific Antigen (PSA) screening at an urban hospital in a designated medically underserved population with an increased incidence of prostate cancer of 21% compared with the general population.[22,23,24]
Our results are in agreement with Aslani et al, where they observed a decline in PSA screening from March 2009 to May 2012 (b = À0.001, p < 0.001), which was continued thereafter with the release of the May 2012 United States Preventative Services Task Force (USPSTF) guidelines.[25]
Summary
Prostate cancer is the second leading cause of cancerrelated death in men.[1]. Prostate Specific Antigen (PSA)screening offers improved detection rates of prostate cancer with the downside of overtreatment of low-risk disease.[2,3] Treatment is often associated with significant side effects causing a change in quality of life related to urinary, sexual, and bowel function.[4]. Prostate cancer is the second leading cause of cancerrelated death in men.[1] Prostate Specific Antigen (PSA). Two large but controversial randomized trials assessed the impact of prostate cancer screening on mortality and became the basis for recommendations by the United States Preventative Services Task Force (USPSTF). The Prostate, Lung, Colorectal and Ovarian (PLCO) trial assigned over 75,000 men to annual PSA screening and a similar self-reported ‘‘control’’ group who did not undergo regimented PSA screening. PLCO reported no difference in cancer-specific mortality at 10 years between the two groups.[7] The control group of the PLCO trial appears to have undergone equal or more intense PSA screening than the arm assigned to PSA testing.[8]
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