scholarly journals Application of Bootstrap Resampling Technique to Obtain Confidence Interval for Prostate Specific Antigen (PSA) Screening Age

2020 ◽  
Vol 9 (2) ◽  
pp. 177-179
Author(s):  
Shabih Manzar
Keyword(s):  
Confidence Interval ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Bootstrap Resampling ◽  
Psa Screening

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.

scholarly journals Patient Provider Continuity and Prostate Specific Antigen Testing: Impact of Continuity on Receipt of a Non-recommended Test

2021 ◽  
Vol 8 ◽  
Author(s):  
Arch G. Mainous ◽  
Benjamin J. Rooks ◽  
Elvira S. Mercado ◽  
Peter J. Carek
Keyword(s):  
Prostate Specific Antigen ◽  
Continuity Of Care ◽  
Specific Antigen ◽  
Behavioral Risk ◽  
Psa Test ◽  
Advantages And Disadvantages ◽  
Psa Screening ◽  
Personal Doctor ◽  
Nationally Representative ◽  
To Receive

Background: Continuity of care with a regular physician has been associated with treatment adherence but it is unclear if continuity of care may lead to inappropriate treatments. We assessed the relationship between the receipt of prostate-specific antigen (PSA) screening, a non-recommended test, and having continuity with a single personal doctor.Methods: We analyzed the 2016 and 2018 Behavioral Risk Factor Surveillance System (BRFSS). Responses from men aged 40 and older with no symptoms or family history of prostate cancer were analyzed (unweighted n = 232,548, representing 36,919,766 individuals). Continuity with one doctor was analyzed in relation to discussions of advantages and disadvantages of PSA tests, provider recommendation to receive a test and receipt of a PSA test.Results: 39.5% of men received PSA screening during the time that the test was not recommended. Having a single personal doctor was associated with discussion of both advantages (53.3 vs. 29.7%, p &lt; 0.001) and disadvantages (24.2 vs. 13.5%, p &lt; 0.001) of PSA tests but also a recommendation to receive a PSA test (45.3 vs. 29.3%, p &lt; 0.001). The adjusted odds of receiving a PSA test was higher among those with a single personal doctor compared to those without (OR 2.31; 95% CI, 2.17–2.46).Conclusion: In a nationally representative sample during the time when PSA screening was not recommended by the US Preventive Services Taskforce, having a single personal doctor was associated with both recommendations for the test and receipt of the test. These findings emphasize the importance of the patient physician relationship and the need for evidence-based care.

Prostate cancer and prostate-specific antigen (PSA) screening in Austria

2005 ◽  
Vol 117 (13-14) ◽  
pp. 457-461 ◽  
Author(s):  
Christian Vutuc ◽  
Eva S. Schernhammer ◽  
Gerald Haidinger ◽  
Thomas Waldhör
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Psa Screening

scholarly journals Prostate specific antigen (PSA) screening rates and factors associated with screening in Eastern Canadian men: Findings from cross-sectional survey data

2020 ◽  
Vol 14 (7) ◽  
Author(s):  
Devan Tchir ◽  
Marwa Farag ◽  
Michael Szafron
Keyword(s):  
Prostate Specific Antigen ◽  
Smoking Status ◽  
Specific Antigen ◽  
Age Groups ◽  
Canadian Community Health Survey ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Psa Screening

Introduction: The prostate-specific antigen (PSA) test is used in Canada to detect prostate cancer (PCa) despite mixed recommendations. Complications arising from false-positives are common, posing as a cancer-screening concern. This work estimates some Canadian rates of PSA screening and identifies men at increased odds for PSA screening. Methods: The Canadian Community Health Survey (CCHS) from 2009/10 (Atlantic Canada; ATL), 2011/2012 (Ontario; ON), and 2013/2014 (Quebec; QC) were used. Lifetime and recent PSA screening with confidence intervals were constructed to estimate PSA screening in ATL, ON, and QC. Two logistic regression models (for men <50 and ≥50 years of age) were used to determine associations between factors and lifetime PSA screening. Results: PSA screening rates have increased in most age groups for ATL, ON, and QC since 2000/2001. Factors positively associated with lifetime PSA screening in men of all ages were: having a digital rectal exam, having a regular doctor, and having a colorectal exam. Fruit and vegetables consumption and non-smoking status were positively associated with lifetime PSA screening in men <50 years of age. High income and the presence of chronic health conditions were positively associated with lifetime PSA screening in men ≥50 years of age. Conclusions: PSA screening rates have generally increased since 2000/2001 in Canada. Physician-related factors play a role in men at all ages, while different factors are associated in men <50 years of age and men ≥50 years of age. Limitations include the generalizability to all of Canada and the potential for recall bias.

scholarly journals The Proportion of Prostate-specific Antigen (PSA) Complexed to α1-Antichymotrypsin Improves the Discrimination between Prostate Cancer and Benign Prostatic Hyperplasia in Men with a Total PSA of 10 to 30 μg/L

2002 ◽  
Vol 48 (8) ◽  
pp. 1251-1256 ◽  
Author(s):  
Manuel Martínez ◽  
Francisco España ◽  
Montserrat Royo ◽  
José M Alapont ◽  
Silvia Navarro ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Confidence Interval ◽  
Diagnostic Accuracy ◽  
Prostate Specific Antigen ◽  
Correct Diagnosis ◽  
Specific Antigen ◽  
Prostatic Hyperplasia ◽  
Total Psa ◽  
L 14

Abstract Background: The aim of this study was to assess the diagnostic accuracy of the proportion of prostate-specific antigen (PSA) complexed to α1-antichymotrypsin (PSA-α1ACT:PSA ratio) in the differential diagnosis of prostate cancer (CaP) and benign prostatic hyperplasia (BPH) in men with total PSA of 10–30 μg/L. Methods: We used our immunoassays (ELISAs) for total PSA and PSA-α1ACT complex to study 146 men. In 123, total PSA was between 10 and 20 μg/L; 66 of these had CaP and 57 BPH. In 23 men, total PSA was between 20 and 30 μg/L; 14 of these had CaP and 9 BPH. We calculated the area under the ROC curves (AUC) for total PSA, PSA-α1ACT complex, and PSA-α1ACT:PSA ratio, and determined the cutoff points that gave sensitivities approaching 100%. Results: In the total PSA range between 10 and 20 μg/L, the AUC was significantly higher for the PSA-α1ACT:PSA ratio (0.850) than for total PSA (0.507) and PSA-α1ACT complex (0.710; P &lt;0.0001). A cutoff ratio of 0.62 would have permitted diagnosis of all 66 patients with CaP (100% sensitivity) and avoided 19% of unnecessary biopsies (11 of 57 patients). In the total PSA range between 20 and 30 μg/L, the AUC for the PSA-α1ACT:PSA ratio (0.980; 95% confidence interval, 0.82–0.99) was greater than the AUC for total PSA (0.750; 95% confidence interval, 0.51–0.89; P = 0.042). In this range, a cutoff point of 0.64 would have permitted the correct diagnosis of all 14 patients with CaP and 6 of the 9 with BPH. Conclusions: The diagnostic accuracy of the PSA-α1ACT:PSA ratio persists at high total PSA concentrations, increasing the specificity of total PSA. Prospective studies with large numbers of patients are needed to assess whether the ratio of PSA-α1ACT to total PSA is a useful tool to avoid unnecessary prostatic biopsy in patients with a total PSA &gt;10 μg/L.

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