Afshin Aslani1, Brian J Minnillo1, Ben Johnson1, Edward E Cherullo1, Lee E Ponsky1, Robert Abouassaly2. 1. Department of Urology, Case Western Reserve University, Urological Institute, University Hospitals Case Medical Center, Cleveland, Ohio. 2. Department of Urology, Case Western Reserve University, Urological Institute, University Hospitals Case Medical Center, Cleveland, Ohio. Electronic address: robert.abouassaly@uhhospitals.org.
Abstract
PURPOSE: The United States Preventive Services Task Force recently recommended against routine prostate cancer screening, stating that the risks of screening outweigh the benefits. We determined the impact of this recommendation on prostate cancer screening in a large health system. MATERIALS AND METHODS: We obtained data on all screening prostate specific antigen tests performed at University Hospitals Case Medical Center and affiliated hospitals in northeastern Ohio from January 2008 to December 2012. We examined the total number of prostate specific antigen tests ordered with time and adjusted for patient volume by fitting a regression line. The overall trend was examined and stratified by location (urban, suburban or rural), patient age and provider type (primary care or urology). RESULTS: A total of 43,498 screening prostate specific antigen tests were performed from January 2008 to December 2012. Most tests were ordered by specialists in internal medicine (64.9%), followed by family medicine (23.7%), urology (6.1%) and hematology/oncology (1.3%). Prostate specific antigen screening increased with time until March 2009, when initial screening trials were published. Prostate specific antigen testing then decreased significantly and continued to decrease after the task force recommendations. Similar patterns were noted in almost all subgroups. The greatest decrease in screening was observed by urologists and in patients in the intermediate age group (50 to 59 years). CONCLUSIONS: United States Preventive Services Task Force recommendations appeared to have decreased prostate cancer screening. The greatest impact was seen for urologists and patients in the intermediate age group. Further study is needed to determine the long-term effects of these recommendations on the screening, diagnosis, treatment and prognosis of this prevalent malignancy.
PURPOSE: The United States Preventive Services Task Force recently recommended against routine prostate cancer screening, stating that the risks of screening outweigh the benefits. We determined the impact of this recommendation on prostate cancer screening in a large health system. MATERIALS AND METHODS: We obtained data on all screening prostate specific antigen tests performed at University Hospitals Case Medical Center and affiliated hospitals in northeastern Ohio from January 2008 to December 2012. We examined the total number of prostate specific antigen tests ordered with time and adjusted for patient volume by fitting a regression line. The overall trend was examined and stratified by location (urban, suburban or rural), patient age and provider type (primary care or urology). RESULTS: A total of 43,498 screening prostate specific antigen tests were performed from January 2008 to December 2012. Most tests were ordered by specialists in internal medicine (64.9%), followed by family medicine (23.7%), urology (6.1%) and hematology/oncology (1.3%). Prostate specific antigen screening increased with time until March 2009, when initial screening trials were published. Prostate specific antigen testing then decreased significantly and continued to decrease after the task force recommendations. Similar patterns were noted in almost all subgroups. The greatest decrease in screening was observed by urologists and in patients in the intermediate age group (50 to 59 years). CONCLUSIONS: United States Preventive Services Task Force recommendations appeared to have decreased prostate cancer screening. The greatest impact was seen for urologists and patients in the intermediate age group. Further study is needed to determine the long-term effects of these recommendations on the screening, diagnosis, treatment and prognosis of this prevalent malignancy.
Authors: E David Crawford; Matt T Rosenberg; Alan W Partin; Matthew R Cooperberg; Michael Maccini; Stacy Loeb; Curtis A Pettaway; Neal D Shore; Paul Arangua; John Hoenemeyer; Mike Leveridge; Michael Leapman; Peter Pinto; Ian M Thompson; Peter Carroll; James Eastham; Leonard Gomella; Eric A Klein Journal: Urology Date: 2016-07-19 Impact factor: 2.649
Authors: Daniel J Becker; Temitope Rude; Dawn Walter; Chan Wang; Stacy Loeb; Huilin Li; Shannon Ciprut; Matthew Kelly; Steven B Zeliadt; Angela Fagerlin; Herbert Lepor; Scott Sherman; Joseph E Ravenell; Danil V Makarov Journal: J Natl Cancer Inst Date: 2021-05-04 Impact factor: 13.506