Decrease in Prostate Cancer Testing Following the US Preventive Services Task Force (USPSTF) Recommendations

Abstract

Purpose: To assess changes of prostate-specific antigen (PSA) testing following recent US Preventive Services Task Force (USPSTF) prostate cancer screening recommendations using 2005 to 2013 National Health Interview Survey data.

Methods: We calculated the percentage of PSA testing among men ≥40 years by age group and age-adjusted race for each survey year. Differences between years were assessed with linear contrasts after combining all years' data.

Results: The overall percentage of PSA testing was highest in 2008 and decreased significantly in 2013. Compared with 2008, each age group had significantly lower screening percentages in 2013, especially men ≥75 years old (-14.0% points; P < .001). Both men aged 50 to 74 and men aged ≥75 had significantly lower percentages in 2013 than in 2010. For white and black men, the PSA testing percentages were highest in 2008 and decreased significantly in 2013. Only white men had a significantly lower percentage in 2013 than in 2010.

Conclusions: Significant declines in PSA testing from 2008 to 2013 in men ≥75 years old may reflect the impact of the 2008 USPSTF recommendations. While the cause of the decreases in PSA testing between 2010 and 2013 among men aged 50 to 74 years old and white men is unknown, the decreases may suggest the early effects of the 2012 recommendations.

Keywords: Cancer Screening; Prostate Cancer; Prostate-Specific Antigen.

Figure 1.

Percentage of prostate-specific antigen testing within the past year, by age and year, among men aged ≥40 years, based on National Health Interview Survey 2005 to 2013 data. Percentages are weighted to the noninstitutionalized male population.

Figure 2.

Percentage of prostate-specific antigen testing within the past year, by race and year, among men aged ≥40 years and older, based on National Health Interview Survey 2005 to 2013 data. Percentages of race are age-adjusted to the 2010 US standard population and are weighted to the noninstitutionalized male population. American Indians and Alaska Natives are not presented because of the small sample sizes. API, Asian/Pacific Islander.