Reduction in number of men screened for and diagnosed with prostate cancer
Rates of prostate cancer screening and diagnosis have dropped.
HealthDay News — Fewer U.S. men are being screened for prostate cancer, and fewer cases of the disease are being diagnosed nationwide. These findings, published in the Journal of the American Medical Association, suggest that the U.S. Preventive Services Task Force (USPSTF) recommendations have had an impact.
In one study, researchers with the American Cancer Society found that in 2013, 31% of U.S. men age 50 and older said they'd had a prostate-specific antigen (PSA) test in the past year. That was down from 38% in 2010, and about 41% in 2008 — the year the USPSTF began advising against routine PSA testing for men ages 75 and up. At the same time, diagnoses of prostate cancer declined nationwide — from more than 213,000 men in 2011, to about 180,000 in 2012.
The second study, by researchers from Brigham and Women's Hospital and Dana-Farber Cancer Institute in Boston, and Henry Ford Health System in Detroit, looked only at screening rates and found a similar pattern. The largest decline in PSA screening was among men ages 60 to 64: In 2010, 45% underwent screening, versus 35% in 2013. Men ages 50 to 54 also saw a big decline, with just 18% getting a PSA test in 2013, compared to 23% in 2010.
"Certainly, physicians have been overly aggressive in their approach to prostate cancer screening and treatment during the past two decades, but the pendulum may be swinging back the other way," David Penson, MD, MPH, a urologic surgeon at Vanderbilt University in Nashville, Tenn., writes in an editorial published with the studies. "It is time to accept that prostate cancer screening is not an 'all-or-none' proposition and to accelerate development of personalized screening strategies that are tailored to a man's individual risk and preferences."
- Jemal A, Fedewa SA, Ma J, et al. Prostate Cancer Incidence and PSA Testing Patterns in Relation to USPSTF Screening Recommendations. JAMA. 2015;314(19):2054-2061. doi:10.1001/jama.2015.14905.
- Sammon JD, Abdollah F, Choueiri TK, et al. Prostate-Specific Antigen Screening After 2012 US Preventive Services Task Force Recommendations. JAMA. 2015;314(19):2077-2079. doi:10.1001/jama.2015.7273.
- Penson DF. The Pendulum of Prostate Cancer Screening. JAMA. 2015;314(19):2031-2033. doi:10.1001/jama.2015.13775.