Reply to Letter to the Editor Re: Generalizability of prostate-specific antigen (PSA) screening trials in a “real world” setting: a nationwide survey analysis

Urology ◽  
2021 ◽  
Author(s):  
Deepansh Dalela ◽  
Firas Abdollah
Keyword(s):  
Prostate Specific Antigen ◽  
Real World ◽  
Specific Antigen ◽  
Nationwide Survey ◽  
Survey Analysis ◽  
Psa Screening ◽  
Real World Setting ◽  
Letter To The Editor ◽  
Screening Trials

Impact of Prostate-specific Antigen (PSA) Screening Trials and Revised PSA Screening Guidelines on Rates of Prostate Biopsy and Postbiopsy Complications

2017 ◽  
Vol 71 (1) ◽  
pp. 55-65 ◽  
Author(s):  
Boris Gershman ◽  
Holly K. Van Houten ◽  
Jeph Herrin ◽  
Daniel M. Moreira ◽  
Simon P. Kim ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Screening Guidelines ◽  
Psa Screening ◽  
Screening Trials

Prostate-specific antigen testing in the disabled population: A cross-sectional analysis of the Health Information National Trends Survey (HINTS).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17000-e17000
Author(s):  
Joon Yau Leong ◽  
Ruben Pinkhasov ◽  
Thenappan Chandrasekar ◽  
Oleg Shapiro ◽  
Michael Daneshvar ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Information ◽  
Prostate Specific Antigen ◽  
Healthcare Provider ◽  
Specific Antigen ◽  
Cross Sectional ◽  
Psa Screening ◽  
Psa Testing ◽  
The Usa ◽  
National Trends

e17000 Background: Disabled patients are a unique minority population that may have lower literacy levels and difficulty communicating with physicians. Furthermore, their knowledge for cancer prevention recommendations is unknown. Herein, we aim to compare prostate-specific antigen (PSA) testing rates and associated predictors among disabled men and non-disabled men in the USA. Methods: We performed a cross-sectional study utilizing the Health Information National Trends Survey (HINTS) to analyze factors predicting PSA testing rates in men with disabilities (disabled, deaf, blind). Multivariable logistic regression models were used to determine clinically significant predictors of PSA testing in men with disabilities compared to that of the healthy cohort. Results: A total of 782 (14.6%) disabled men were compared to 4,569 (85.4%) non-disabled men. Disabled men were older with a mean age of 65.0 ± 14.2 vs. 55.0 ± 15.9 years (p < 0.001). On multivariable analysis, after adjusting for all available confounders including race, age, geographical region, survey year, marital status, health insurance, healthcare provider, amongst others, men with any disability were less likely to undergo PSA screening (OR 0.772, 95% CI 0.623-0.956, p = 0.018). Variables associated with increased PSA screening rates included age, having a healthcare provider or health insurance, and living with a partner. Although prostate cancer detection rates were shown to be higher among disabled men, this did not reach statistical significance. Conclusions: Our data suggests that significant inequalities in PSA screening exist among men with disabilities in the USA, with disabled men, especially the deaf and the blind, being less likely to be offered PSA screening. There is a clear need to implement strategies to reduce existing gaps in the care of disabled men and strive to reach equality in PSA screening in this unique population.

THE ACCURACY AND EFFECTIVENESS OF ROUTINE POPULATION SCREENING WITH MAMMOGRAPHY, PROSTATE-SPECIFIC ANTIGEN, AND PRENATAL ULTRASOUND

2001 ◽  
Vol 17 (3) ◽  
pp. 275-304 ◽  
Author(s):  
Steven H. Woolf
Keyword(s):  
Breast Cancer ◽  
Prostate Specific Antigen ◽  
False Positive ◽  
Congenital Anomalies ◽  
Specific Antigen ◽  
Prenatal Ultrasound ◽  
Screening Tests ◽  
Published Data ◽  
Psa Screening ◽  
Abnormal Results

Objective: To review published data regarding the accuracy and effectiveness of three screening tests: mammography, prostate-specific antigen (PSA), and prenatal ultrasound.Methods: Published evidence regarding the accuracy and effectiveness of the three tests was collected by computerized literature search and supplemented by manual review of relevant bibliographies.Results: Screening mammograms lower breast cancer mortality by about 20%. Most data come from women aged 50–64 years; women aged 40–49 years may also benefit, but the absolute risk reduction is lower. Up to 1,500 to 2,500 women must undergo screening to prevent one death from breast cancer. Mammograms miss approximately 12% to 37% of cancers, generate false-positive results, and cause anxiety while abnormal results are evaluated. PSA screening can detect 80% to 85% of prostate cancers but has a high false-positive rate. There is little direct evidence that early detection reduces morbidity or mortality. Indirect evidence includes a trend toward earlier stage tumors and steadily declining mortality rates in geographic areas where PSA screening has become common. Potential harms include the morbidity associated with evaluating abnormal results, and complications from treatment (e.g., impotence, incontinence). The overall balance of benefits and harms remains uncertain in the absence of better evidence. Prenatal ultrasound may reduce perinatal mortality, primarily through elective abortions for congenital anomalies, but does not appear to lower live birth rates. Although ultrasound has no proven effect on neonatal morbidity, it provides more accurate estimates of gestational age that prevent unnecessary inductions for post-term pregnancy. Screening detects multiple gestations, congenital anomalies, and intrauterine growth retardation, but direct health benefits from having this knowledge are unproved. Ultrasound has both positive and negative psychological effects on parents. The scans do not appear to harm childhood development.Conclusions: Even for the most established screening tests, the appropriateness of routine testing depends on subjective value judgments about the quality of supporting evidence and about the trade-offs between benefits and harms. Individuals, clinicians, policy makers, and governments must weigh the evidence in light of these values and the constraints imposed by available resources.

scholarly journals Prevalence and Predictors of Routine Prostate-specific Antigen Screening in Medicare Beneficiaries in the USA: Retrospective Cohort Analysis Using Machine Learning

2019 ◽  
Vol 12 (1) ◽  
pp. 521-531
Author(s):  
Ashis Kumar Das ◽  
Saji Saraswathy Gopalan
Keyword(s):  
Machine Learning ◽  
Prostate Specific Antigen ◽  
Retrospective Cohort ◽  
Medicare Beneficiary ◽  
Cohort Analysis ◽  
Specific Antigen ◽  
Medicare Beneficiaries ◽  
Screening Uptake ◽  
Psa Screening ◽  
Retrospective Cohort Analysis

Objective: To estimate the prevalence and predictors of Prostate-Specific Antigen (PSA) screening among Medicare beneficiary men using machine learning algorithms. Methods: A retrospective cohort analysis used the Medicare Current Beneficiary Survey Public Use File (MCBS PUF) data from 2015 and 2016. Predictors of PSA screening were examined through multivariable logistic regression and machine learning techniques. Results: Over half (56%) of Medicare beneficiary men had PSA screening during 2015-2016. Ages between 65 and 75 years, education above high school, being married, higher annual income (>$25,000), being overweight or obese, and more than 20 outpatient office visits were significant predictors. Conclusion: PSA screening uptake was 56 percent among Medicare beneficiaries and it was driven by beneficiaries’ age, education, marital status, income, body mass index, and number of outpatient visits. Although Medicare provides free annual PSA screening, uptake was higher among high-income beneficiaries. Awareness strategies would help inform privileges for PSA screening under Medicare and the advantages of routine screening for mitigating the health risks.

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