scholarly journals PSA screening, prostate biopsy, and treatment of prostate cancer in the years surrounding the USPSTF recommendation against prostate cancer screening

Cancer ◽  
2018 ◽  
Vol 124 (13) ◽  
pp. 2733-2739 ◽  
Author(s):  
James T. Kearns ◽  
Sarah K. Holt ◽  
Jonathan L. Wright ◽  
Daniel W. Lin ◽  
Paul H. Lange ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Biopsy ◽  
Prostate Cancer Screening ◽  
Psa Screening

Prognostic Significance of a Negative Prostate Biopsy: An Analysis of Subjects Enrolled in a Prostate Cancer Screening Trial

2017 ◽  
Vol 197 (4) ◽  
pp. 1014-1019 ◽  
Author(s):  
Patrick Lewicki ◽  
Jonathan Shoag ◽  
David M. Golombos ◽  
Clara Oromendia ◽  
Karla V. Ballman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Biopsy ◽  
Prostate Cancer Screening ◽  
Prognostic Significance ◽  
Cancer Screening Trial ◽  
Screening Trial ◽  
Negative Prostate Biopsy

scholarly journals Prostate cancer screening among family physicians in Ontario: An update on attitudes and current practice

2017 ◽  
Vol 12 (2) ◽  
pp. E53-8 ◽  
Author(s):  
Jason Paul Akerman ◽  
Christopher B. Allard ◽  
Camilla Tajzler ◽  
Anil Kapoor
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Task Force ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Family Physicians ◽  
Preventive Health Care ◽  
The United States ◽  
Screening Practices ◽  
Psa Screening

Introduction: This study serves as an update of prostate cancer screening practices among family physicians in Ontario, Canada. Since this population was first surveyed in 2010, the Canadian Task Force on Preventive Health Care (CTFPHC) and the United States Preventive Services Task Force (USPSTF) released recommendations against prostate cancer screening.Methods: An online survey was developed through input from urologists and family practitioners. It was distributed via email to all members of the Ontario Medical Association’s Section on General and Family practice (11 657 family physicians). A reminder email was sent at two weeks and the survey remained active for one month.Results: A total of 1880 family physicians completed surveys (response rate 16.1%). Overall, 80.4% offered prostate cancer screening compared to 91.7% when surveyed in 2010. Physicians new to practice (two years or less) were the most likely to not offer screening (24.6%). A combination of digital rectal exam (DRE) and prostate-specific antigen (PSA) remained the most common form of screening (58.3%). Following the release of the CTFPHC recommendations, 45.6% of respondents said they now screen fewer patients. Participants were less familiar with national urological society guidelines compared to task force recommendations. The majority (72.6%) of respondents feel PSA screening leads to overdiagnosis and treatment. Those surveyed remained split with respect to PSA utility.Conclusions: Data suggest a decline in screening practices since 2010, with newer graduates less likely to offer screening. CFTPHC and USPSTF recommendations had the greatest impact on clinical practice. Those surveyed were divided with respect to PSA utility. Some additional considerations to PSA screening in the primary care setting, including patient-driven factors, were not captured by our concise survey.

The cost implications of prostate cancer screening in the Medicare population.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6549-6549
Author(s):  
Xiaomei Ma ◽  
Rong Wang ◽  
Jessica B. Long ◽  
Joseph S. Ross ◽  
Pamela R. Soulos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Initial Treatment ◽  
Prostate Cancer Screening ◽  
Fee For Service ◽  
Psa Screening ◽  
Screening Cost ◽  
Hospital Referral ◽  
The Cost ◽  
Biopsy Complications

6549 Background: Recent debate about prostate specific antigen (PSA)-based testing for prostate cancer screening among older men has rarely considered the cost associated with screening. Methods: We assembled a population-based cohort of male Medicare beneficiaries aged 66-99 years who had never been diagnosed with prostate cancer at the end of 2005 (n = 84,699) and followed them for two years to assess the cost of PSA screening and downstream procedures (biopsy, pathology, and hospitalization due to biopsy complications) at both the national and the hospital referral region (HRR) level. The relation of screening cost to stage of prostate cancer at diagnosis at the HRR level was analyzed using multivariate Poisson models. We also evaluated the initial treatment cost of Medicare fee for service beneficiaries diagnosed with prostate cancer during 2006-2007 (n = 31,653). Results: Approximately 42.8% of the 84,699 men received PSA screening tests during the two-year study period, with 2.4% undergoing biopsy. The annual expenditures by the national fee for service Medicare program were $454 million for screening and $1.79 billion for initial treatment (in 2009 US dollars). The mean annual screening cost at the regional (HRR) level ranged from $16 to $65 per beneficiary. Downstream biopsy-related procedures (biopsy, pathology, and hospitalization due to biopsy complications) accounted for 73% of the overall screening costs and varied significantly across regions. Compared with men residing in HRRs that were in the lowest quartile for screening expenditures, men living in the highest HRR quartile were significantly more likely to be diagnosed with prostate cancer of any stage [incidence rate ratio (IRR) = 1.23, 95% confidence interval (CI): 1.07-1.42] and localized cancer (IRR = 1.31, 95% CI: 1.13-1.53). Conclusions: Medicare prostate cancer screening-related expenditures are substantial, vary considerably across regions, and are positively associated with rates of cancer diagnosis.

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