PSA screening rates in older men in the United States based on nine-year estimated remaining life expectancy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16006-e16006
Author(s):  
Michael Drazer ◽  
Sandip M. Prasad ◽  
Dezheng Huo ◽  
Mara A Schonberg ◽  
Russell Zelig Szmulewitz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Life Expectancy ◽  
National Health Interview Survey ◽  
Older Men ◽  
The United States ◽  
Informed Decision Making ◽  
Remaining Life ◽  
Psa Screening ◽  
Interview Survey ◽  
Remaining Life Expectancy

e16006 Background: PSA screening for prostate cancer (PCa) is controversial, but informed decision making is recommended for men with an estimated 10 years of remaining life expectancy (RLE). The association between screening of men 65+ and estimated 9-year life expectancy is unknown. Our purpose was to determine the association between predicted 9-year life expectancy and PCa screening in 2005 and 2010. Methods: Data were extracted from the 2005 and 2010 National Health Interview Survey. Men 65+ without prostate known PCa were divided into quartiles with a validated index estimating 9-year RLE (<27%, 27-52%, 53-75%, and >75%). The proportions of men screened in 2005 and 2010 were determined. Logistic regression was used to compare screening in 2005 and 2010. Results: Screening rates for men 65+ were 48.3% (95% CI, 45.6-50.9%) in 2005 and 48.5% (95% CI, 45.5-51.6%) in 2010 (p = 0.9). There were no differences in screening between cohorts by age and predicted mortality for 65-74 (all p > 0.05 for <27%, 27-52%, 53-75%, and >76% predicted mortality) and 75+ year olds (all p> 0.05). The most screened group were 65-74 year olds with a <27% chance of 9-year mortality, with 58.3% (95% CI, 53.6–63.1) and 56.1% (95% CI, 50.6-61.5) screened in 2005 and 2010. Conclusions: PSA-based PCa screening did not differ between 2005 and 2010 for men 65+. Over 35% and 33% of older men with limited estimated 9-year RLE were screened in 2005 and 2010 despite minimal clinical benefit. [Table: see text]

scholarly journals Remaining life expectancy measurement and PSA screening of older men

2012 ◽  
Vol 3 (3) ◽  
pp. 196-204 ◽  
Author(s):  
Ashwin A. Kotwal ◽  
Supriya G. Mohile ◽  
William Dale
Keyword(s):  
Life Expectancy ◽  
Older Men ◽  
Remaining Life ◽  
Psa Screening ◽  
Remaining Life Expectancy

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.

Screening for cancer

2017 ◽  
pp. 707-712
Author(s):  
Anne Horgan ◽  
Shabbir M. H. Alibhai
Keyword(s):  
Prostate Cancer ◽  
Older Adults ◽  
Life Expectancy ◽  
Early Identification ◽  
Remaining Life ◽  
Supportive Evidence ◽  
Curative Intent ◽  
Remaining Life Expectancy ◽  
Breast And Prostate Cancer ◽  
Potential Methods

Cancer screening is the early identification of an asymptomatic malignancy. The aim of screening is to identify cancer at a stage where it can be more effectively treated and ideally with curative intent. Guidelines regarding screening in the older population differ widely across countries, in part due to the underrepresentation of older adults in the large screening trials on which the recommendations are based. In this chapter, we present the screening recommendations for colorectal, lung, breast, and prostate cancer from four international groups. The benefits of screening in the overall population are highlighted, and the data supporting screening in older adults outlined. Factors to be considered in screening decisions are discussed, including remaining life expectancy and patient and physician wishes. Potential methods to overcome these challenges along with supportive evidence are highlighted.

scholarly journals Nativity and Country of Origin Variations in Life Expectancy With Functional Limitations Among Older Hispanics in the United States

2020 ◽  
Vol 42 (7-8) ◽  
pp. 199-207 ◽  
Author(s):  
Marc A. Garcia ◽  
Adriana M. Reyes ◽  
Catherine García ◽  
Chi-Tsun Chiu ◽  
Grecia Macias
Keyword(s):  
United States ◽  
Life Expectancy ◽  
National Health Interview Survey ◽  
Puerto Ricans ◽  
Functional Limitations ◽  
Country Of Origin ◽  
The United States ◽  
Foreign Born ◽  
Interview Survey ◽  
Racial Ethnic

This study examined racial/ethnic, nativity, and country of origin differences in life expectancy with and without functional limitations among older adults in the United States. We used data from the National Health Interview Survey (1999–2015) to estimate Sullivan-based life tables of life expectancies with functional limitations and without functional limitations by sex for U.S.-born Mexicans, foreign-born Mexicans, U.S.-born Puerto Ricans, island-born Puerto Ricans, foreign-born Cubans, and U.S.-born Whites. We find that Latinos exhibit heterogeneous life expectancies with functional limitations. Among females, U.S.-born Mexicans, foreign-born Mexicans, and foreign-born Cubans spend significantly fewer years without functional limitations, whereas island-born Puerto Ricans spend more years with functional limitations. For men, U.S.-born Puerto Ricans were the only Latino subgroup disadvantaged in the number of years lived with functional limitations. Conversely, foreign-born Cubans spend significantly fewer years without functional limitations. To address disparities in functional limitations, we must consider variation in health among Latino subgroups.

scholarly journals Demographic and Socioeconomic Disparities in Life Expectancy With Hearing Impairment in the United States

2020 ◽  
Author(s):  
Jessica S West ◽  
Scott M Lynch
Keyword(s):  
Life Expectancy ◽  
Hearing Impairment ◽  
The United States ◽  
Hearing Impaired ◽  
Future Research ◽  
Social Disparities ◽  
Remaining Life ◽  
Age Related ◽  
Total Life Expectancy ◽  
Remaining Life Expectancy

Abstract Objectives Hearing impairment is one of the most common disabilities among older people, and its prevalence will increase as the U.S. population ages. However, little is known about social disparities in onset or transitions into and out of hearing impairment, nor how these transitions impact years of life to be spent impaired. Method We investigate the number of years an “average” person can expect to live with and without hearing impairment after age 50; sex, race, educational, and regional differences in these expectancies; and the implication of hearing impairment for remaining life expectancy. Bayesian multistate life table methods are applied to 9 waves of data from the Health and Retirement Study (1998–2014) to investigate social disparities in life expectancy with hearing impairment (n = 20,200) for the general population, people hearing impaired at age 50, and people hearing unimpaired at age 50. Results Men, Hispanics, persons with less educational attainment, and those born in the south can expect to live a larger proportion of their remaining lives hearing impaired. Although transitions from hearing impaired to unimpaired occur, those with some hearing impairment at age 50 can expect to live more years with hearing impairment, and hearing impairment does not shorten remaining life expectancy. Discussion Significant sociodemographic disparities in hearing impaired life expectancy exist. In contrast to past research, we find that hearing impairment does not affect total life expectancy. Future research should consider the consequences of hearing impairment for years to be lived with other age-related and potentially downstream health outcomes.

scholarly journals Vaccinating the oldest against COVID-19 saves both the most lives and most years of life

2021 ◽  
Vol 118 (11) ◽  
pp. e2026322118
Author(s):  
Joshua R. Goldstein ◽  
Thomas Cassidy ◽  
Kenneth W. Wachter
Keyword(s):  
United States ◽  
Life Expectancy ◽  
South Korea ◽  
Health Risks ◽  
Mathematical Analysis ◽  
The United States ◽  
Older Age ◽  
Remaining Life ◽  
Age Patterns ◽  
Remaining Life Expectancy

Many competing criteria are under consideration for prioritizing COVID-19 vaccination. Two criteria based on age are demographic: lives saved and years of future life saved. Vaccinating the very old against COVID-19 saves the most lives, but, since older age is accompanied by falling life expectancy, it is widely supposed that these two goals are in conflict. We show this to be mistaken. The age patterns of COVID-19 mortality are such that vaccinating the oldest first saves the most lives and, surprisingly, also maximizes years of remaining life expectancy. We demonstrate this relationship empirically in the United States, Germany, and South Korea and with mathematical analysis of life tables. Our age-risk results, under usual conditions, also apply to health risks.

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