Population-based prostate cancer trends in the United States: patterns of change in the era of prostate-specific antigen

1997 ◽  
Vol 15 (6) ◽  
pp. 331-335 ◽  
Author(s):  
Robert A. Stephenson ◽  
Janet L. Stanford
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
The United States ◽  
Population Based ◽  
Cancer Trends

RE: THE PROSTATE SPECIFIC ANTIGEN ERA IN THE UNITED STATES IS OVER FOR PROSTATE CANCER: WHAT HAPPENED IN THE LAST 20 YEARS?

2005 ◽  
Vol 173 (6) ◽  
pp. 2205-2205 ◽  
Author(s):  
T.A. Stamey ◽  
M. Caldwell ◽  
J.E. McNeal ◽  
R. Nolley ◽  
M. Hemenez ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
The United States

scholarly journals Population-Based Patterns and Predictors of Prostate-Specific Antigen Screening Among Older Men in the United States

2011 ◽  
Vol 29 (13) ◽  
pp. 1736-1743 ◽  
Author(s):  
Michael W. Drazer ◽  
Dezheng Huo ◽  
Mara A. Schonberg ◽  
Aria Razmaria ◽  
Scott E. Eggener
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Cancer Screening ◽  
Life Expectancy ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Older Men ◽  
The United States ◽  
Population Based ◽  
Psa Screening

Purpose For patients who elect to have prostate cancer screening, the optimal time to discontinue screening is unknown. Our objective was to describe rates and predictors of prostate-specific antigen (PSA) screening among older men in the United States. Methods Data were extracted from the population-based 2000 and 2005 National Health Interview Survey (NHIS). PSA screening was defined as a PSA test as part of a routine exam within the past year. Demographic, socioeconomic, and functional characteristics were collected, and a validated 5-year estimated life expectancy was calculated. Age-specific rates of PSA screening were determined, and sampling weight-adjusted multivariate regressions were fitted to determine predictors of screening among men age 70 years or older. Results The PSA screening rate was 24.0% in men age 50 to 54 years, and it increased steadily with age until a peak of 45.5% among age 70 to 74 years. Screening rates then gradually declined by age, and 24.6% of men age 85 years or older reported being screened. Among men age 70 years or older, screening rates varied by estimated 5-year life expectancy: rates were 47.3% in men with high life expectancies (≤ 15% probability of 5-year mortality), 39.2% in men with intermediate life expectancies (16% to 48% probability), and 30.7% in men with low life expectancies (> 48% probability; P < .001). In multivariate analysis, estimated life expectancy and age remained independently associated with PSA screening (P < .001 for each). Conclusion Rates of PSA screening in the United States are associated with age and estimated life expectancy, but excessive PSA screening in elderly men with limited life expectancies remains a significant problem. The merits and limitations of PSA should be discussed with all patients considering prostate cancer screening.

Prostate-specific antigen testing among primary care physicians and urologists: Patterns of care and impact of professional society guidelines.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 40-40
Author(s):  
Sandip M. Prasad ◽  
G. Caleb Alexander ◽  
Scott E. Eggener
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Specific Antigen ◽  
Primary Care Physicians ◽  
Medical Condition ◽  
Specific Antigen ◽  
The United States ◽  
Chronic Medical Condition ◽  
The Past ◽  
Psa Testing

40 Background: During the past decade, the incidence of prostate cancer in the United States has declined. We hypothesized this was related to lower rates of prostate-specific antigen (PSA) testing and sought to evaluate PSA testing rates nationally. Methods: Using the National Ambulatory Medical Care Survey, a nationally representative sample of outpatient visits in the United States, we analyzed rates of PSA testing in men age 40 years or older who visited PCPs or urologists from 1997 to 2008. Results: An estimated 26.6 million (95% CI: 24.8-28.4 million) PSA tests were ordered during 94.5 million (95% CI: 90.9-98.1 million) office visits to urologists and 95 million (95% CI: 87.5-102.8 million) tests were ordered during 1.17 billion (95% CI: 1.15-1.18 billion) visits to PCPs, with an annual increase of 3.4% and 6.0%, respectively (P=0.055 and P<0.001 for trend). After adjusting for year, race, ethnicity, region, insurance and provider type, testing by PCPs was more likely among older men and highest among men aged 60 to 69 years (reference: 40-49 years; OR 2.32, 95% CI: 1.88-2.85). Compared to men without a chronic medical condition, those with one chronic condition had greater odds of receiving a PSA test (OR 1.28, 95% CI: 1.08-1.52). Conclusions: Prostate cancer incidence has declined over the past decade despite increasing rates of office-based PSA testing by PCPs and urologists during the period. Increasing rates of PSA testing merit scrutiny, especially in men with limited life expectancies who are unlikely to benefit from screening.

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