Prostate-Specific Antigen Testing Rates Appear to Level Off After Recent Drop

Key Points

  • A previous study by ACS investigators showed shifting recommendations had led to a decline in PSA screening rates, which dropped from 37.8% in 2010 to 30.8% in 2013 among men aged 50 years or older.
  • Among men 50 or older, rates of PSA testing for routine reasons in the past year remained stable at 32.1%.  

Declines in prostate-specific antigen (PSA) testing that came after changes in government screening guidelines have abated in recent years, according to a new study. In JAMA Internal Medicine, American Cancer Society (ACS) investigators led by Stacy A. Fedewa, PhD, wrote that about 1 in 3 men aged 50 years or older still receive routine PSA testing.

Recommendations for PSA-based prostate cancer screening have changed considerably in recent years. In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended against PSA-based prostate cancer screening among men aged 75 years or older, and in 2012, the group recommended against PSA testing for men of all ages. Other organizations, including the ACS, emphasize shared decision-making for men 50 years or older who have a long life expectancy.

A previous study by ACS investigators showed shifting recommendations had led to a decline in PSA screening rates, which dropped from 37.8% in 2010 to 30.8% in 2013 among men 50 years or older, resulting in substantial declines in prostate cancer incidence.

Recently Released Data

To find out if the trend has continued, ACS researchers used recently released data from the 2015 National Health Interview Survey (NHIS) to examine testing patterns. They reviewed responses from 16,196 men over 50, more than half of whom were 50 to 64 years old. Three-quarters of the men had visited their primary care physician in the past year. They found that among men 50 years or older, rates of PSA testing for routine reasons in the past year remained stable at 32.1%.  

“Physicians interested in deadopting PSA testing may have done so, closely following the USPSTF recommendation and the media attention that came with it,” wrote the authors. They add that other physicians may be choosing to continue to offer PSA testing based on their beliefs about screening and interpretation of clinical trial results, as well as recommendations from other public health organizations that still support PSA testing, albeit with shared decision-making.

The authors pointed to a recent study that reported a modest short-term increase in the incidence of metastatic prostate cancer among men aged 75 years or older but said continued evaluation is needed to determine how testing patterns influence prostate cancer outcomes over the long term.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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