Abstract
Our goal was to assess temporal changes in the race-specific rates of prostate specific antigen (PSA) screening, prostate biopsy, overall prostate cancer detection and metastatic cancer at presentation among screen-eligible men in Kaiser Permanente Northern California before and after the 2012 United States Preventive Services Task Force Prostate Cancer Screening Statement. This was a retrospective study spanning the years 2006 to 2017 in screen-eligible Kaiser Permanente Northern California members (Black men ages 45-69, all other men ages 50-69) with no history of prostate cancer. We compared the race-specific biennial rates of PSA testing, prostate biopsy, overall prostate cancer incidence and metastatic cancer at presentation. A total of 422,664 to 567,660 men per biennial period were evaluated (72% White, 8% Black, 20% Asian). Following the 2012 United States Preventive Services Task Force statement, all races experienced similar declines in screening (22%-25%), biopsy (47%-57%) and overall cancer detection (34%-48%) rates. We found an increase in metastatic rates (39%-105%). Following the 2012 United States Preventive Services Task Force Statement, in men under the age of 70, PSA screening, biopsy and overall prostate cancer detection rates significantly decreased in a similar fashion across all races, while rates of metastatic disease significantly increased in all races.
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