Abstract B68: Men at high risk for prostate cancer and the prostate-specific antigen (PSA) test: Uptake levels and physician recommendations
Authors: Anderson Meshka , Quinn Gwendolyn , Vadaparampil Susan 
Published: May 2015

Introduction: The Prostate-Specific Antigen (PSA) is a protein secreted by the cells of the prostate gland. Abnormalities in the prostate, such as cancer, can lead to an increase in PSA blood levels. The PSA test was developed for early detection of prostate cancer. Recently, the U.S. Preventive Services Task Force (USPSTF) updated their original 2008 recommendation against the use of PSA screening for men 75 years and older to include men in the general U.S. population of all ages [5]. The arguments made by the USPSTF apply to the general population with average risk, as opposed to men who have increased risk, such as men with the BRCA 1 or 2 mutations. The PSA test may have benefits of early detection of prostate cancer among this population. This study defines ‘high risk’ men as those who had their blood drawn by a nurse or healthcare professional to see if they carried a gene mutation that may confer increased risk for hereditary cancer and aims to investigate the utilization levels of the PSA test among these high risk men and if the test was recommended to them by their physicians.

Methods: Data were gathered from a subset of a survey intended to explore the perceptions and attitudes toward Preimplantation Genetic Diagnosis (PGD) among males who either carry a BRCA mutation or had partners or immediate relatives who had a BRCA mutation [14]. This study focused on analyzing demographics, clinical characteristics, PSA test uptake and physician recommendations. The data were separated into categories of men who indicated that they had a genetic test for hereditary cancer in the past (n=64), and those who had not (n=164). The men who answered ‘yes’ to having had a genetic test in the past were considered high-risk for the purpose of this study.

Results: 58.7% of high-risk men were recommended for the PSA test by their doctor or healthcare provider, while 31.7% had not received a recommendation. Of those men not recommended for a PSA test, 20.0% tested positive for a gene that may put them at increased risk for hereditary cancer. The investigation also revealed that 50.79% of high-risk men utilized the PSA test while 46.03% did not. Among men who did not take the PSA test, 17.2% tested positive for a gene that may put them at increased risk for hereditary cancer.

Conclusion: The results of this study add to the argument that although the PSA test is an effective long-term diagnostic tool, it is only being utilized by about 50% of men who meet the criteria for being at high-risk for developing prostate cancer and physicians are only recommending about 59% of these high-risk men. Physicians should be encouraged to pay close attention to men who show signs of increased hereditary risk and recommend them for long-term PSA monitoring and better efforts should be made to educate the high risk community of men about the benefits of non-invasive PSA monitoring.

Citation Format: Meshka Anderson, Gwendolyn Quinn, Susan Vadaparampil. Men at high risk for prostate cancer and the prostate-specific antigen (PSA) test: Uptake levels and physician recommendations. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B68. doi:10.1158/1538-7755.DISP13-B68