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. 2021 May 4;113(5):626-631.
doi: 10.1093/jnci/djaa120.

The Association of Veterans' PSA Screening Rates With Changes in USPSTF Recommendations

Daniel J Becker  1   2 , Temitope Rude  1   3 , Dawn Walter  1   4 , Chan Wang  4 , Stacy Loeb  1   4 , Huilin Li  4 , Shannon Ciprut  1   3   4 , Matthew Kelly  1   3   4 , Steven B Zeliadt  5 , Angela Fagerlin  6   7 , Herbert Lepor  2   3 , Scott Sherman  1   2   4 , Joseph E Ravenell  4 , Danil V Makarov  1   4   8
Affiliations

The Association of Veterans' PSA Screening Rates With Changes in USPSTF Recommendations

Daniel J Becker et al. J Natl Cancer Inst. .

Abstract

Background: In 2012, the United States Preventative Services Task Force (USPSTF) formally recommended against all prostate-specific antigen (PSA) screening for prostate cancer. Our goal was to characterize PSA screening trends in the Veterans Health Administration (VA) before and after the USPSTF recommendation and to determine if PSA screening was more likely to be ordered based on a veteran's race or age.

Methods: Using the VA Corporate Data Warehouse, we created 10 annual groups of PSA-eligible men covering 2009-2018. We identified all PSA tests performed in the VA to determine yearly rates of PSA screening. All statistical tests were 2-sided.

Results: The overall rate of PSA testing in the VA decreased from 63.3% in 2009 to 51.2% in 2018 (P < .001). PSA screening rates varied markedly by age group during our study period, with men aged 70-80 years having the highest initial rate and greatest decline (70.6% in 2009 to 48.4% in 2018, P < .001). Men aged 55-69 years had a smaller decline (65.2% in 2009 to 58.9% in 2018, P < .001) whereas the youngest men, aged 40-54 years, had an increase in PSA screening (26.2% in 2009 to 37.8% in 2018, P < .001).

Conclusions: In this analysis of PSA screening rates among veterans before and after the 2012 USPSTF recommendation against screening, we found that overall PSA screening decreased only modestly, continuing for more than one-half of the men in our study. Veterans of different races had similar screening rates, suggesting that VA care may minimize racial disparities. Veterans of varying ages experienced statistically significantly differences in PSA screening trends.

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Figures

Figure 1.
Figure 1.
Prostate-specific antigen screening rates in the Veteran’s Affairs, by age group, 2009-2018.
See this image and copyright information in PMC

References

    1. Smith RA, von Eschenbach AC, Wender R, et al.American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001—testing for early lung cancer detection. CA Cancer J Clin. 2001;51(1):38-75; quiz 77-80. - PubMed
    1. Carroll P, Coley C, McLeod D, et al.Prostate-specific antigen best practice policy—part I: early detection and diagnosis of prostate cancer. Urology. 2001;57(2):217-224. - PubMed
    1. Preventive U.S. Services Task Force. Screening for prostate cancer: recommendation and rationale. Ann Intern Med. 2002;137(11):915-916. - PubMed
    1. Carter HB, Albertsen PC, Barry MJ, et al.Early detection of prostate cancer: AUA guideline. J Urol. 2013;190(2):419-426. - PMC - PubMed
    1. American Cancer Society. Cancer Facts & Figures for African Americans 2016-2018. Atlanta, GA: American Cancer Society; 2016.

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