scholarly journals Prostate-Specific Antigen Screening According to Health Professional Counseling and Age in the United States

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Ray M. Merrill ◽  
Seth A. Otto ◽  
Eliza B. Hammond
Keyword(s):  
Health Professional ◽  
Task Force ◽  
Specific Antigen ◽  
The United States ◽  
Screening Methods ◽  
Professional Counseling ◽  
Psa Test ◽  
Psa Screening ◽  
The Past ◽  
The Us

Background. In 2018, the US Preventive Services Task Force recommended that PSA screening for prostate cancer involve men aged 55–69, based on a personal decision following consultation with a health professional. PSA screening in men aged 70 or older should only occur if symptoms exist. This study identifies the association between having a PSA test in the past two years and whether or not there was consultation with a health professional about the benefits and/or harms of PSA screening. Methods. Analyses were based on data involving men aged 40 years or older, who responded to PSA related questions in the 2018 BRFSS survey. Results. Approximately 32.0% (14.6% for ages 40–54, 41.7% for ages 55–69, and 49.8% for ages 70 years and older) of respondents had a PSA test in the past two years. Approximately 81.7% of these men had talked with a health professional about the benefits and/or harms of PSA screening, with 42.4% having discussed the benefits and harms, 54.6% having discussed the benefits only, and 3.0% having discussed the harms only. The odds of a PSA test in the past two years in men having talked with a health professional about the benefits and harms of the test versus no talk are 10.1 (95% CI 9.3–10.8), in men who talked with a health professional about the benefits only versus no talk are 10.8 (95% CI 10.0–11.6), and in men who talked with a health professional about the harms only versus no talk are 3.9 (95% CI 2.9–5.1). Conclusion. PSA screening is most common in men aged 70 or older, which is counter to the US Preventive Task Force recommendation. Most men having a PSA test have talked with a health professional about the test, but the talks tended to focus on just the benefits of screening and not both potential benefits and harms.

Implications of the United States Preventive Services Task Force (USPSTF) recommendations on prostate cancer (PCa) stage migration.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5071-5071
Author(s):  
Iris Yeong- Fung Sheng ◽  
Yu-Wei Chen ◽  
Moshe Chaim Ornstein ◽  
Timothy D. Gilligan ◽  
Brian I. Rini ◽  
...  
Keyword(s):  
Task Force ◽  
Financial Burden ◽  
Specific Antigen ◽  
The United States ◽  
Stage Migration ◽  
Psa Screening ◽  
Group 3 ◽  
Group 2 ◽  
The Impact ◽  
Group 1

5071 Background: Prostate specific antigen (PSA) screening has been controversial, given unrefined screening guidelines leading to overdiagnosis and overtreatment of “indolent” PCa. In 2008, the USPSTF recommended against PSA screening for men aged ≥75 and in 2012 broadened this recommendation to include all men. The impact of these changes is unstudied. We hypothesize that these screening changes could delay the diagnosis of advanced PCa. Methods: The Surveillance, Epidemiology and End Results Program (SEER) was used to identify men (age 55-69) diagnosed with PCa between 2004-2015. PCa stage was categorized as nodal (N1M0) and metastatic (NxM1). Trend analysis was stratified based on year 2004-2008 (group 1), 2009-2012 (group 2), and 2012-2015 (group 3). Using group 2 as a reference, multivariable logistic regression was used to identify predictors for N1M0 and NxM1 in each group. Results: From 2004-2015, there were 603,323 eligible men diagnosed with PCa (group 1: 262,240 men, group 2: 210,045 men, group 3: 131,038 men). In group 1, 1.4% had N1M0 and 2.8% had NxM1. In group 2, 1.6% had N1M0 and 3.7% had NxM1. In group 3, 1.4% had N1M0, and 6.1% had NxM1. The adjusted odds ratio (AOR) of N1M0 was 0.78 (95%CI 0.74-0.82; p<0.0001) in group 1 and 1.71 (95%CI 1.63-1.80; p<0.0001) in group 3. Similar AOR trends were seen in NxM1 (group 1, 0.71; 95%CI 0.68-0.73, p< 0.0001 vs. group 3, 1.70; 95% CI 1.63-1.75, p<0.0001). (Table) Subset analysis of non-eligible patients (age >70 and <55) showed a similar stage migration. Conclusions: With each USPSTF recommendation, there have been significantly more diagnoses of advanced PCa; suggesting stage migration. The sequelae of having advanced PCa include more aggressive treatments, increased financial burden, and reduced quality of life. Future population studies are warranted to investigate whether the updated 2018 USPSTF recommendation now encapsulates the best target population.[Table: see text]

Impact of USPSTF recommendations on utilization of PSA screening in Medicare beneficiaries.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 166-166
Author(s):  
Rahul Ramesh Khairnar ◽  
Mark Mishra ◽  
Ebere Onukwugha
Keyword(s):  
Task Force ◽  
Specific Antigen ◽  
Age Groups ◽  
The United States ◽  
Study Cohort ◽  
Administrative Claims ◽  
Medicare Beneficiaries ◽  
Psa Screening ◽  
Medicare Population ◽  
The Impact

166 Background: Previous studies assessing the impact of the United States Preventive Services Task Force (USPSTF) recommendations on utilization of prostate-specific antigen (PSA) screening have not investigated longer-term impacts of the 2008 recommendations nor have they investigated the impact of the 2012 recommendations in the Medicare population. The study aim was to evaluate change in utilization of PSA screening, post USPSTF recommendations of 2008 and 2012, and to assess trends and determinants of receipt of PSA screening in the Medicare population. Methods: This retrospective study of male Medicare beneficiaries utilized Medicare Current Beneficiary Survey (MCBS) data and linked administrative claims from 2006-2013. Beneficiaries aged ≥65 years, with continuous enrollment in Parts A and B for each year they were surveyed were included in the study cohort. Beneficiaries with self-reported or claims-based diagnosis of prostate cancer were excluded. Beneficiaries with Medicare eligibility due to end stage renal disease or disability were also excluded. The primary outcome was receipt of PSA screening. Other measures include age groups (65-74 and ≥75), time periods (pre- and post-2008 and 2012 recommendations), and sociodemographic variables. Results: The study cohort consisted of 11,028 beneficiaries, who were predominantly white (87.56%), married (69.25%), and unemployed (84.4%); 52.21% beneficiaries were aged ≥75. Declining utilization trends for PSA screening were observed only in men aged ≥75 after 2008 recommendations and in both age groups after 2012 recommendations. The odds of receiving PSA screening declined by 17% percent in men aged ≥75 after the 2008 recommendations and by 29% in men aged ≥65 after the 2012 recommendations. Conclusions: The USPSTF recommendations of 2008 and 2012 against PSA screening were associated with declines in utilization of PSA screening during the study period. USPSTF recommendations play a significant role in affecting utilization patterns of health services. Future studies should evaluate if the proposed 2017 update to these recommendations advocating shared decision-making for PSA screening in men aged 55-69 increase utilization in this age-group.

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.

scholarly journals The Association of Veterans’ PSA Screening Rates With Changes in USPSTF Recommendations

2020 ◽  
Author(s):  
Daniel J Becker ◽  
Temitope Rude ◽  
Dawn Walter ◽  
Chan Wang ◽  
Stacy Loeb ◽  
...  
Keyword(s):  
Task Force ◽  
Statistical Tests ◽  
Specific Antigen ◽  
The United States ◽  
Veterans Health ◽  
Health Administration ◽  
Psa Screening ◽  
Psa Testing ◽  
Before And After ◽  
Preventative Services

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 &lt; .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 &lt; .001). Men aged 55-69 years had a smaller decline (65.2% in 2009 to 58.9% in 2018, P &lt; .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 &lt; .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.

Assessment of compliance with USPSTF lung cancer screening guidelines among resident primary care physicians in a university residency program.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 43-43
Author(s):  
Nerea Lopetegui-Lia ◽  
Syed Imran Jafri ◽  
Manish Kumar ◽  
Shashank Sama ◽  
James J. Vredenburgh
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Primary Care Physicians ◽  
Task Force ◽  
Lung Cancer Screening ◽  
The United States ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Screening Methods ◽  
The Us

43 Background: Lung cancer remains the leading cause of morbidity and mortality, with a predicted 1.8 million deaths worldwide yearly. The United States Preventive Services Task Force (USPSTF) recommends screening for lung cancer with Low Dose Computed Tomography (LDCT) for all genres of age 55 to 80 with a 30 pack-year smoking history, current smokers or have quit within the past 15 years. Early detection has shown to reduce mortality. Only 4% of eligible patients in the US actually undergo lung cancer screening. Methods: A retrospective review of data was performed amongst the University of Connecticut Internal Medicine Residents acting as PCPs at a Clinic in Hartford, CT, USA. Results: 369 medical charts were reviewed. 115 patients (31.1%) met the USPSTF criteria for screening. 5.7% had an appropriately ordered LDCT scan. 2.71% had a LDCT completed and 2.98% had LDCT scheduled but pending or cancelled. 4 patients with smoking history who did not meet USPSTF criteria but had a LDCT due to clinical suspicion for lung cancer. Approximately 11% of patients had chronic obstructive pulmonary disease (COPD) or emphysema and asthma. 5 patients had a first degree relative with history of lung cancer. 6 patients had lung cancer, 3 of which had metastatic lung cancer at the time of diagnosis and are deceased. Conclusions: Lung cancer screening amongst resident PCP is insufficient. The results obtained were lower than the national average. This is likely due to newer trainees focusing less in prevention/screening and more on managing chronic medical conditions. Patients that attend resident PCP clinics in the US are typically of lower socio-economic status, less insurance coverage or uninsured and with a lower level of education. LDCT orders that were cancelled were likely because insurers declined it. Patients not realizing the importance of screening could also be contributing. It is unclear if lung disease or family history attributes a higher risk of developing lung cancer. In conclusion, educating resident PCPs and patients on lung cancer screening, as well as evaluating the reasons for cancelling LDCT could help ensure high quality care.

Palestine Unbound

2018 ◽  
Vol 47 (3) ◽  
pp. 130-134
Keyword(s):  
United States ◽  
Human Rights ◽  
Task Force ◽  
The United States ◽  
Donald Trump ◽  
Tel Aviv ◽  
The Us ◽  
Intention To Move ◽  
Arab Israeli Conflict ◽  
The U.S

This section, updated regularly on the blog Palestine Square, covers popular conversations related to the Palestinians and the Arab-Israeli conflict during the quarter 16 November 2017 to 15 February 2018: #JerusalemIstheCapitalofPalestine went viral after U.S. president Donald Trump recognized Jerusalem as the capital of Israel and announced his intention to move the U.S. embassy there from Tel Aviv. The arrest of Palestinian teenager Ahed Tamimi for slapping an Israeli soldier also prompted a viral campaign under the hashtag #FreeAhed. A smaller campaign protested the exclusion of Palestinian human rights from the agenda of the annual Creating Change conference organized by the US-based National LGBTQ Task Force in Washington. And, UNRWA publicized its emergency funding appeal, following the decision of the United States to slash funding to the organization, with the hashtag #DignityIsPriceless.

The Riddle of a Common History

2009 ◽  
Vol 1 (1) ◽  
pp. 93-116 ◽  
Author(s):  
Mauricio Tenorio-Trillo
Keyword(s):  
United States ◽  
Common Ground ◽  
The United States ◽  
History Textbooks ◽  
Recent History ◽  
History Textbook ◽  
The Past ◽  
The Us ◽  
Constant Part ◽  
Intrinsic Component

By identifying two general issues in recent history textbook controversies worldwide (oblivion and inclusion), this article examines understandings of the United States in Mexico's history textbooks (especially those of 1992) as a means to test the limits of historical imagining between U. S. and Mexican historiographies. Drawing lessons from recent European and Indian historiographical debates, the article argues that many of the historical clashes between the nationalist historiographies of Mexico and the United States could be taught as series of unsolved enigmas, ironies, and contradictions in the midst of a central enigma: the persistence of two nationalist historiographies incapable of contemplating their common ground. The article maintains that lo mexicano has been a constant part of the past and present of the US, and lo gringo an intrinsic component of Mexico's history. The di erences in their historical tracks have been made into monumental ontological oppositions, which are in fact two tracks—often overlapping—of the same and shared con ictual and complex experience.

scholarly journals Association between food insecurity and access to a mental health professional: cross-sectional analysis of NHANES 2007–2014

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Camille Burruss ◽  
Marina Girgis ◽  
Karen Elizabeth Green ◽  
Lingyi Lu ◽  
Deepak Palakshappa
Keyword(s):  
Mental Health ◽  
Health Professional ◽  
Food Insecurity ◽  
Mental Health Professional ◽  
The United States ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
The Past ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Abstract Background To determine if individuals with food insecurity (FI) were less likely to have seen a mental health professional (MHP) within the past year than individuals without FI. Methods This is a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States between 2007 and 2014. All participants 20 years of age or older were eligible for this study. We excluded participants who were pregnant, missing FI data, or missing data from the Patient Health Questionnaire (PHQ-9). The primary outcome was self-reported contact with a MHP in the past 12 months. We used multivariable logistic regression models to test the association between FI and contact with a MHP, controlling for all demographic and clinical covariates. Results Of the 19,789 participants, 13.9% were food insecure and 8.1% had major depressive disorder (MDD). In bivariate analysis, participants with FI were significantly more likely to have MDD (5.3% vs 2.8%, p < 0.0001) and to have been seen by a MHP in the preceding 12 months (14.0% vs 6.9%, p < 0.0001). In multivariable models, adults with FI had higher odds of having seen a MHP (OR = 1.32, CI: 1.07, 1.64). Conclusions This study demonstrates that individuals with FI were significantly more likely to have seen a MHP in the preceding 12 months compared to individuals without FI. Given the growing interest in addressing unmet social needs in healthcare settings, this data suggests that visits with MHPs may be a valuable opportunity to screen for and intervene on FI.

Abstract P183: 20-year Secular Trend of Cardiovascular Disease Comorbidities in the United States, 1997-2016

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Dianjianyi Sun ◽  
Tao Zhou ◽  
Xiang Li ◽  
Yoriko Heianza ◽  
Xiaoyun Shang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Secular Trend ◽  
Adult Population ◽  
The United States ◽  
The Past ◽  
The Us ◽  
Metabolic Conditions ◽  
Respiratory Conditions ◽  
The U.S ◽  
Chronic Comorbidities

Background: Cardiovascular disease (CVD) has been the number one cause of death and disability in the US and globally for decades, and its comorbidity complicates the management of CVD. However, little is known about the secular trend of CVD comorbidities in national representative populations in the last 20 years. Methods: Prevalence of CVD and nine major chronic comorbidities was estimated using data from 1,324,214 adults aged 18 years and older in the National Health Interview Survey (NHIS) from 1997 through 2016, with age-standardized to the U.S. population in the year 2000. Results: CVD prevalence in the US adult population significantly declined in the past twenty years (from 6.6% in 1997 to 5.9% in 2016, P trend <0.01in Figure a). And such trend was shown in women and whites (P trend <0.01), but not in men and blacks (P trend >0.05). We ranked the nine major chronic comorbidities (high to low) in the CVD patients (Figure b.), including (1) hypertension, (2) respiratory conditions, (3) nervous system conditions, (4) digestive conditions, (5) diabetes, (6) cancer, (7) genitourinary conditions, (8) circulatory conditions, and (9) endocrine/nutritional/metabolic conditions. From 1997 to 2016, the prevalence of CVD comorbidities including hypertension (38.8% to 50.2%), digestive conditions (17.0% to 27.1%), diabetes (10.0% to 19.2%), cancer (9.4% to 12.8%), and genitourinary conditions (4.1% to 5.2%) continuingly increased (all P trend <0.01), while respiratory conditions declined (35.9% to 27.6%, P trend <0.01). Similar trends of CVD comorbidities were observed among subgroups stratified by gender or by race. Conclusions: CVD prevalence in the U.S. adults have declined significantly in the past two decades, but rates of CVD comorbidities including hypertension, digestive conditions, diabetes, cancer, and genitourinary conditions increased substantially.

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