PSA screening rates in older men in the United States based on nine-year estimated remaining life expectancy.

Abstract

e16006 Background: PSA screening for prostate cancer (PCa) is controversial, but informed decision making is recommended for men with an estimated 10 years of remaining life expectancy (RLE). The association between screening of men 65+ and estimated 9-year life expectancy is unknown. Our purpose was to determine the association between predicted 9-year life expectancy and PCa screening in 2005 and 2010. Methods: Data were extracted from the 2005 and 2010 National Health Interview Survey. Men 65+ without prostate known PCa were divided into quartiles with a validated index estimating 9-year RLE (<27%, 27-52%, 53-75%, and >75%). The proportions of men screened in 2005 and 2010 were determined. Logistic regression was used to compare screening in 2005 and 2010. Results: Screening rates for men 65+ were 48.3% (95% CI, 45.6-50.9%) in 2005 and 48.5% (95% CI, 45.5-51.6%) in 2010 (p = 0.9). There were no differences in screening between cohorts by age and predicted mortality for 65-74 (all p > 0.05 for <27%, 27-52%, 53-75%, and >76% predicted mortality) and 75+ year olds (all p> 0.05). The most screened group were 65-74 year olds with a <27% chance of 9-year mortality, with 58.3% (95% CI, 53.6–63.1) and 56.1% (95% CI, 50.6-61.5) screened in 2005 and 2010. Conclusions: PSA-based PCa screening did not differ between 2005 and 2010 for men 65+. Over 35% and 33% of older men with limited estimated 9-year RLE were screened in 2005 and 2010 despite minimal clinical benefit. [Table: see text]