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. 2015;17(3):171-7.

Impact of the US Preventive Services Task Force Grade D Recommendation: Assessment of Evaluations for Elevated Prostate-specific Antigen and Prostate Biopsies in a Large Urology Group Practice Following Statement Revision

Kathleen F McGinley, Gregory C McMahon  1 , Gordon A Brown
Affiliations

Impact of the US Preventive Services Task Force Grade D Recommendation: Assessment of Evaluations for Elevated Prostate-specific Antigen and Prostate Biopsies in a Large Urology Group Practice Following Statement Revision

Kathleen F McGinley et al. Rev Urol. 2015.

Abstract

On October 7, 2011, the United States Preventive Services Task Force (USPSTF) released their evidence statement and grade D recommendation against prostate-specific antigen (PSA)-based prostate cancer screening. Using a time series design, we assessed the effect of this recommendation upon evaluations for elevated PSA levels and prostate biopsies in our large urology group practice. We found that, despite a 24.1% increase in total visits, the 32 urologists in our practice completed 16.4% fewer evaluations for elevated PSA levels (317 fewer evaluations per month; P = .017) and 21.4% fewer prostate biopsies (42 fewer biopsies per month; P = .001) in the 2 years following the USPSTF grade D recommendation.

Keywords: Prostate biopsies; Prostate cancer screening; Prostate-specific antigen; United States.

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Figures

Figures 1
Figures 1
Number of practice office visits per year from October 2010 to September 2013. Over this time period, visits increased from 103,600 (October 2010-September 2011) to 114,163 (October 2011–September 2012) to 128,531 (October 2012–September 2013), representing annual increases of 10.2% and 12.6%, respectively. USPSTF, United States Preventive Services Task Force.
Figures 2
Figures 2
Monthly total of evaluations for elevated PSA performed from October 2010 to September 2013 at Delaware Valley Urology, LLC (Voorhees, NJ). In the 2 years following release of the USPSTF grade D recommendation, evaluations for elevated PSA decreased by 317 visits per month (95% CI: −573, −61; P = .017). CI, confidence interval; PSA, prostate-specific antigen; USPSTF, United States Preventive Services Task Force.
Figures 3
Figures 3
Monthly totals of prostate biopsies performed from October 2010 to September 2013 at Delaware Valley Urology, LLC (Voorhees, NJ). In the 2 years following release of the USPSTF grade D recommendation, prostate biopsies decreased by 42 biopsies per month (95% CI: −64, −19; P = .001). USPSTF, United States Preventive Services Task Force.
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