Prostate‐specific antigen testing in older men in the USA: data from the behavioral risk factor surveillance system

• Published in: BJU international Vol. 110; no. 10; pp. 1485 - 1490
• Main Authors: Scosyrev, Emil, Wu, Guan, Golijanin, Dragan, Messing, Edward
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Age; Aged; Aged, 80 and over; Behavioral Risk Factor Surveillance System; Biological and medical sciences; BRFSS; Elderly; Guideline Adherence; Gynecology. Andrology. Obstetrics; Humans; Life span; Male; Male genital diseases; Males; Medical sciences; Medical screening; Men; Morbidity; Nephrology. Urinary tract diseases; Practice Guidelines as Topic; Prostate cancer; Prostate-Specific Antigen - blood; Prostatic Neoplasms - diagnosis; PSA; Risk factors; Task forces; Tumors; Tumors of the urinary system; United States; Urinary tract. Prostate gland; United States; North America; America; USA; Human; Nephrology; Urinary system disease; Prostate disease; Male; Tumoral marker; Malignant tumor; Medical screening; Epidemiology; Behavioral Risk Factor Surveillance System; Urology; Prostate specific antigen; Surveillance; Risk factor; Adult; Male genital diseases; Prostate cancer; Elderly; Age; BRFSS; Cancer; PSA
• ISSN: 1464-4096; 1464-410X; 1464-410X
• DOI: 10.1111/j.1464-410X.2012.11013.x

Study Type – Diagnosis (cohort) Level of Evidence 2a What's known on the subject? and What does the study add? Previous studies from the USA reported that, in recent years, prostate cancer screening with PSA was very common among the elderly men, including those whose life expectancy was substantially limited by advanced age and known comorbidities. In 2008, the US Preventive Services Task Force (USPSTF) recommended against PSA screening after age 75. The purpose of this study was to examine the impact of the USPSTF 2008 recommendation on the frequency of PSA testing among elderly men in the USA. Our findings suggest that the USPSTF recommendation had no major impact on clinical practice. OBJECTIVE •  To examine the frequency of PSA testing in men aged ≥75 years before and after the 2008 US Preventive Services Task Force (USPSTF) recommendation to stop prostate‐specific antigen (PSA) screening at age 75. MATERIALS AND METHODS •  Data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) surveys completed in 2006, 2008 and 2010. •  Men aged ≥ 76 years at the time of survey and without a prostate cancer diagnosis were included in the study. •  The percentage of men who had a PSA test in the year before the survey was computed separately for survey years 2006, 2008 and 2010. RESULTS •  The estimated percentages of men with a PSA test in the year before the survey were 60% (95% CI: 58–62%), based on 9033 respondents interviewed in 2006, 63% (95% CI: 62–65%), based on 12 063 respondents interviewed in 2008, and 60% (95% CI: 59–61%), based on 14 782 respondents interviewed in 2010. CONCLUSION •  No substantial reduction in the frequency of PSA testing was observed in the BRFSS 2010 survey data compared with the earlier years, suggesting that the USPSTF 2008 recommendation had no major impact on the frequency of PSA testing in older men in the USA.