scholarly journals Racial and Ethnic Variation in PSA Testing and Prostate Cancer Incidence Following the 2012 USPSTF Recommendation

2020 ◽  
Author(s):  
Kevin H Kensler ◽  
Claire H Pernar ◽  
Brandon A Mahal ◽  
Paul L Nguyen ◽  
Quoc-Dien Trinh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Cancer Incidence ◽  
Race And Ethnicity ◽  
Task Force ◽  
Prostate Cancer Screening ◽  
Disease Incidence ◽  
Specific Antigen ◽  
Prostate Cancer Incidence ◽  
Psa Testing

Abstract Background The 2012 US Preventive Services Task Force recommendation against routine prostate-specific antigen (PSA) testing led to a decrease in prostate cancer screening, but the heterogeneity of its impact by race and ethnicity remains unclear. Methods The proportion of 40- to 74-year-old men who self-reported receiving a routine PSA test in the past year was estimated in the Behavioral Risk Factor Surveillance System (2012-2018). Odds ratios (ORs) of undergoing screening by race and ethnicity were estimated, adjusting for healthcare–related factors. Prostate cancer incidence rates and rate ratios (IRRs) by race and ethnicity were estimated using Surveillance, Epidemiology, and End Results registry data (2004-2017). Results PSA testing frequencies were 32.3% (95% confidence interval [CI] = 31.7% to 32.8%) among non-Hispanic White (NHW), 30.3% (95% CI = 28.3% to 32.3%) among non-Hispanic Black (NHB), 21.8% (95% CI = 19.9% to 23.7%) among Hispanic, and 17.7% (95% CI = 14.1% to 21.3%) among Asian and Pacific Islander men in 2012. The absolute screening frequency declined by 9.5% from 2012 to 2018, with a larger decline among NHB (11.6%) than NHW men (9.3%). The relative annual decrease was greater among NHB (OR = 0.86, 95% CI = 0.84 to 0.88) than NHW men (OR = 0.89, 95% CI = 0.89 to 0.90; Pheterogeneity = .005), driven by a larger decline among NHB men ages 40-54 years. The NHB to NHW IRR for total prostate cancer increased from 1.73 (95% CI = 1.69 to 1.76) in 2011 to 1.87 (95% CI = 1.83 to 1.92) in 2012 and has remained elevated, driven by differences in localized tumor incidence. Metastatic disease incidence is rising across all racial and ethnic groups. Conclusions The frequency of prostate cancer screening varies by race and ethnicity, and there was a modestly steeper decline in PSA testing among younger NHB men relative to NHW men since 2012. The NHB to NHW IRR for localized prostate cancer modestly increased following 2012.

Prostate cancer screening and incidence among men younger than age 50.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 183-183
Author(s):  
J. Li ◽  
R. German ◽  
J. King ◽  
D. Joseph ◽  
T. Thompson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Incidence Rate ◽  
Cancer Incidence ◽  
Prostate Cancer Screening ◽  
Statistical Significance ◽  
Specific Antigen ◽  
Incidence Rates ◽  
Prostate Cancer Incidence ◽  
Well Differentiated

183 Background: Prostate cancer has long been considered as a disease of older men. However, age at diagnosis with prostate cancer has continued to decline. Since the introduction of prostate-specific antigen (PSA) test in 1986, the prostate cancer incidence rate has steadily and dramatically increased in men under age 50. This study aims to better understand demographic variations in prostate cancer screening and incidence, and clinical characteristics of prostate cancers in men under age 50. Methods: We examined prostate cancer testing data from the Behavioral Risk Factor Surveillance System (2002, 2004, 2006, and 2008) and prostate cancer incidence data from the CDC's National Program of Cancer Registries and the NCI's Surveillance, Epidemiology, and End Results programs (2001-2006). We estimated the weighted percentage of self-reported cancer testing using SUDAAN and age-adjusted cancer incidence rates and trends using SEER-STAT. Statistical significance for trends was determined by the annual percentage change (APC) differing form zero. Results: A total of 29,176 prostate cancer cases were identified from 2001-2006 among men under age 50. Of these, 551 (1.9%) were among men under age 40. Incidence rates remained stable from 2001-2006; however the incidence of well-differentiated tumors decreased significantly (APC=−24.7) during this time period. About 44% of men aged 40-49 years old reported having a prostate cancer test in the past two years. Prostate cancer testing and incidence rates were highest among men who were black, non-Hispanic, or lived in the northeast. Black men had more than a 2-fold increase in cancer incidence than white men. Conclusions: The magnitude of prostate cancer testing and incidence in men under age 50 reveals significant health/public health problems in this younger population. This study demonstrates substantial regional differences in prostate cancer testing and incidence in men under age 50. It also confirms that prostate cancer testing and incidence varies by race and ethnicity. We observed a large disparity in prostate cancer incidence between blacks and whites. The incidence rate remained stable over time; the dramatic decrease occurred in well-differentiated cancers. No significant financial relationships to disclose.

Trends in Prostate Specific Antigen (PSA) testing and prostate cancer incidence and mortality in Australia: A critical analysis

2022 ◽  
Vol 77 ◽  
pp. 102093
Author(s):  
Thanya Pathirana ◽  
Rehan Sequeira ◽  
Chris Del Mar ◽  
James A. Dickinson ◽  
Bruce K. Armstrong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Cancer Incidence ◽  
Critical Analysis ◽  
Specific Antigen ◽  
Prostate Cancer Incidence ◽  
Psa Testing ◽  
Incidence And Mortality

scholarly journals Prostate Cancer Screening in the Workplace

AAOHN Journal ◽  
1998 ◽  
Vol 46 (8) ◽  
pp. 379-384 ◽  
Author(s):  
Claire Snyder ◽  
Peggy N. Schrammel ◽  
Claudia B. Griffiths ◽  
Robert I. Griffiths
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Screening Tests ◽  
Test Results ◽  
Total Cost ◽  
Screening Programs ◽  
Psa Testing ◽  
The Cost

Recognition of the mortality and morbidity associated with prostate cancer has resulted in employer based screening programs. This retrospective cohort study identified the employer costs of prostate cancer screening and referrals due to abnormal test results. The subjects were 385 men enrolled in a workplace screening program at a single employer between 1993 and 1995. Screening consisted of digital rectal examination (DRE) annually for enrolled employees aged 40 years and older, plus annual prostate specific antigen (PSA) testing for those 50 and older, and those 40 and older and considered at high risk. Data related to the health care and lost productivity costs of screening and referrals for abnormal test results were collected and analyzed. The total cost of screening was $44,355, or approximately $56 per screening encounter (788 DREs; 437 PSAs). Abnormal screening tests resulted in 52 referrals. Upon further evaluation, 42% were found to have an enlargement, 29% a node, and 12% benign prostatic hyperplasia. Only one malignancy was found. The total cost of additional referrals was $31,815, or 42% of the cost of screening plus referrals. As the cost per screening encounter was low, prostate cancer screening in the workplace is an efficient alternative.

scholarly journals Prostate cancer incidence among finasteride and alpha-blocker users in the Finnish Prostate Cancer Screening Trial

2009 ◽  
Vol 101 (5) ◽  
pp. 843-848 ◽  
Author(s):  
T J Murtola ◽  
T L J Tammela ◽  
L Määttänen ◽  
M Ala-opas ◽  
U H Stenman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Cancer Incidence ◽  
Prostate Cancer Screening ◽  
Prostate Cancer Incidence ◽  
Alpha Blocker ◽  
Cancer Screening Trial ◽  
Screening Trial

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.

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