Study: PSA screening declining in post-USPSTF era

New research shows a significant decrease in PSA screening by primary care physicians since the release of the United States Preventive Services Task Force (USPSTF) recommendation against screening in May 2012.

The decline in prostate cancer screening is particularly pronounced in the oldest and youngest men, study authors from the University of Chicago reported online in Urologic Oncology: Seminars and Original Investigations (Aug. 1, 2013).

Researchers led by Brian T. Helfand, MD, PhD, identified more than 112,000 men who met their inclusion criteria for the study: those between 40 and 79 years of age with no history of prostate cancer or urology visit and who were evaluated by an internal medicine or family practice physician between 2007 and 2012. Analyses were aimed at PSA testing within the 6-month time period from June to November, with particular focus on the 2011 (pre-USPSTF recommendation) and 2012 (post-USPSTF recommendation) cohorts.

The primary outcome was proportion of men with one or more PSA tests during the 6-month pre- and post-USPSTF recommendation periods.

A significant decrease in screening frequency was seen between the 2011 and 2012 cohorts (8.6% vs. 7.6%, p=.0001; adjusted odds ratio: 0.89, 95% confidence interval: 0.83-0.95).

“This decrease was most evident amongst patients aged 40 to 49 years (5.6% vs. 4.6%, p=.004) and 70 to 79 years (7.9% vs. 6.2%, p=.01),” the authors wrote. A significant decrease was also observed in men with PSA values <2.5 ng/mL (p=.0074).

Primary care physicians, according to the researchers, “may be shifting toward more selective screening practices, as decreases in screening are most pronounced in the youngest and oldest patients and in those with history of PSA values <2.5 ng/mL.”

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