The Roles of Providers and Patients in the Overuse of Prostate-Specific Antigen Screening in the United States
Authors: Fangjian Guo, Di He
Journal: Annals of Internal Medicine (2015)

Letters20 October 2015The Roles of Providers and Patients in the Overuse of Prostate-Specific Antigen Screening in the United StatesFangjian Guo, MD, PhD and Di He, MSFangjian Guo, MD, PhDFrom Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch, Galveston, Texas; and David Eccles School of Business, The University of Utah, Salt Lake City, Utah. and Di He, MSFrom Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch, Galveston, Texas; and David Eccles School of Business, The University of Utah, Salt Lake City, Utah.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5150 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Most guidelines recommend against using prostate-specific antigen (PSA) testing to screen a population for prostate cancer on the basis of findings from 2 large clinical trials—the U.S. PLCO (Prostate, Lung, Colorectal, and Ovarian) Cancer Screening Trial (1) and the ERSPC (European Randomized Study of Screening for Prostate Cancer) (2). However, this test is still widely used for screening in the United States, and understanding why this practice persists is important.Objective: To measure the percentage of PSA tests in U.S. adult men that are done on a physician's recommendation versus a patient's request.Methods and Findings: The National Health ...References1. Andriole GL, Crawford ED, Grubb RL, Buys SS, Chia D, Church TR, et al; PLCO Project Team. Prostate cancer screening in the randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial: mortality results after 13 years of follow-up. J Natl Cancer Inst. 2012;104:125-32. [PMID: 22228146] doi:10.1093/jnci/djr500 CrossrefMedlineGoogle Scholar2. Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al; ERSPC Investigators. Prostate-cancer mortality at 11 years of follow-up. N Engl J Med. 2012;366:981-90. [PMID: 22417251] doi:10.1056/NEJMoa1113135 CrossrefMedlineGoogle Scholar3. Hayes JH, Barry MJ. Screening for prostate cancer with the prostate-specific antigen test: a review of current evidence. JAMA. 2014;311:1143-9. [PMID: 24643604] doi:10.1001/jama.2014.2085 CrossrefMedlineGoogle Scholar4. Pickles K, Carter SM, Rychetnik L. Doctors' approaches to PSA testing and overdiagnosis in primary healthcare: a qualitative study. BMJ Open. 2015;5:e006367. [PMID: 25783420] doi:10.1136/bmjopen-2014-006367 CrossrefMedlineGoogle Scholar5. Shelton JB, Ochotorena L, Bennett C, Shekelle P, Kwan L, Skolarus T, et al. Reducing PSA-based prostate cancer screening in men aged 75 years and older with the use of highly specific computerized clinical decision support. J Gen Intern Med. 2015;30:1133-9. [PMID: 25740462] doi:10.1007/s11606-015-3249-y CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch, Galveston, Texas; and David Eccles School of Business, The University of Utah, Salt Lake City, Utah.Note: All data from NHANES (National Health and Nutrition Examination Survey) used in this study were collected by the National Center for Health Statistics for the Centers for Disease Control and Prevention.Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention, National Center for Health Statistics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, or National Institutes of Health.Primary Funding Source: Dr. Guo is currently supported by an institutional training grant (National Research Service Award T32HD055163) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0220. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPatient-Initiated Prostate Cancer Screening Among Older U.S. Men Fangjian Guo Patient-Initiated Prostate Cancer Screening Among Older U.S. Men Michael W. Drazer and Scott E. Eggener Metrics Cited byDiscontinuing Cancer Screening for Older Adults: a Comparison of Clinician Decision-Making for Breast, Colorectal, and Prostate Cancer ScreeningsClinician Perspectives on Overscreening for Cancer in Older Adults With Limited Life ExpectancyAre We Choosing Wisely? Older Adults' Cancer Screening Intentions and Recalled Discussions with Physicians About StoppingCommunicating About Stopping Cancer Screening: Comparing Clinicians' and Older Adults' PerspectivesPatient-Initiated Prostate Cancer Screening Among Older U.S. MenMichael W. Drazer, MD and Scott E. Eggener, MD 20 October 2015Volume 163, Issue 8Page: 650-651KeywordsAntigensChild healthHealth statisticsHealth surveysHispanic peopleOvarian cancer screeningProstate cancerProstate diseasesResearch grantsStatistical data ePublished: 20 October 2015 Issue Published: 20 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...