Use of the prostate‐specific antigen (PSA) test in the United States for men age ≥65, 1999–2015: Implications for practice interventions

Details

• Alternative Title:
  Cancer Rep (Hoboken)
• Personal Author:
  Shahangian, Shahram ; Fan, Lin ; Sharma, Krishna P. ; Siegel, David A.
• Description:
  Background
  
  Various professional organizations have issued recommendations on use of the PSA test to screen for prostate cancer in different age groups.
  
  Aims
  
  Using Medicare claims databases, we aimed to determine rates of PSA testing in the context of screening recommendations during 1999–2015 for US men age ≥65, stratified by age group and census regions, after excluding claims relating to all prostate‐related conditions.
  
  Methods and Results
  
  Medicare claims databases encompassed 9.71–11.12 million men for the years under study. PSA testing rate was the proportion of men with ≥1 test(s) per 12 months of continuous enrollment. Men diagnosed with any prostate‐related condition were excluded. Annual percent change (APC) in PSA test use was estimated using joinpoint regression analysis. In 1999–2015, annual testing rate was 10.1%–23.1%, age ≥85; 16.6%–31.0%, age 80–84; 23.8%–35.8%, age 75–79; 28.3%–36.9%, age 70–74; and 26.4%–33.6%, age 65–69. From 1999 to 2015, PSA testing rate decreased 40.7%, 29.9%, 13.9%, and 2.9%, respectively, for men age ≥85, 80–84, 75–79, and 70–74. For men age 65–69, test use increased by 0.3%. Significant APC trends were: APC1999–2002 = +8.1%, P = .029 and APC2008–2015 = −9.0%, P < .001 for men age ≥85; APC2008–2015 = −7.1%, P = .001 for men age 80–84; APC2001–2015 = −2.5%, P < .001 for men age 75–79; APC2008–2015 = −3.3%, P = .007 for men age 70–74; and APC2010–2015 = −5.2%, P = .014 for men age 65–69.
  
  Coclusion
  
  Although decreased from 1999 to 2015, PSA testing rates remained high for men age ≥70. Further research could help understand why PSA testing continues inconsistent with recommendations.
  
  
• Subjects:
  Administrative Claims, Healthcare Aged Aged, 80 And Over Age Factors Early Detection Of Cancer History, 20th Century History, 21st Century Humans Kallikreins Male Medicare Practice Patterns, Physicians' Prostate-Specific Antigen Prostatic Neoplasms

  More +
• Source:
  Cancer Rep (Hoboken). 4(4)
• Pubmed ID:
  33932150
• Pubmed Central ID:
  PMC8388175
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Volume:
  4
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1516e5b6b552f0f4c4babdc352a0579ae4869788c2ed4330fd72aad2233ec7af
• Download URL:
  https://stacks.cdc.gov/view/cdc/121626/cdc_121626_DS1.pdf
• File Type:
  [PDF - 1.89 MB ]