Is Prostate-Specific Antigen Screening “Proven Ineffective Care”?
Authors: Michael J. Barry, Peter C. Albertsen
Journal: Annals of Internal Medicine (2016)

Ideas and Opinions17 May 2016Is Prostate-Specific Antigen Screening “Proven Ineffective Care”?Michael J. Barry, MD and Peter C. Albertsen, MDMichael J. Barry, MDFrom Massachusetts General Hospital, Boston, Massachusetts, and University of Connecticut School of Medicine, Farmington, Connecticut.Search for more papers by this author and Peter C. Albertsen, MDFrom Massachusetts General Hospital, Boston, Massachusetts, and University of Connecticut School of Medicine, Farmington, Connecticut.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-3025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Institute for Healthcare Improvement Triple Aim framework promotes the following 3 goals: improving the patient experience of care (both quality and satisfaction), improving the health of the population, and reducing per capita costs of care (1). Most measures for health care quality address the first 2 aims by focusing on the delivery of effective care. For example, the Centers for Medicare & Medicaid Services (CMS) maintains sets of quality measures that address care delivered in various environments. Examples include prescription of aspirin at discharge for patients who were admitted with acute myocardial infarction and administration of the influenza vaccine ...References1. Institute for Healthcare Improvement. IHI Triple Aim Initiative. Accessed at www.ihi.org/engage/initiatives/tripleaim/Pages/default.aspx on 12 December 2015. Google Scholar2. Russell LB. Preventing chronic disease: an important investment, but don't count on cost savings. Health Aff (Millwood). 2009;28:42-5. [PMID: 19124852] doi:10.1377/hlthaff.28.1.42 CrossrefMedlineGoogle Scholar3. American Board of Internal Medicine Foundation. Choosing Wisely. Accessed at www.choosingwisely.org/about-us on 12 December 2015. Google Scholar4. National Committee for Quality Assurance. HEDIS 2015: Non-Recommended PSA-Based Screening in Older Men. Accessed at www.ncqa.org/Portals/0/HomePage/Compiled_PC_Materials.pdf on 12 December 2015. Google Scholar5. U.S. Preventive Service Task Force. Prostate Cancer: Screening. Accessed at www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/prostate-cancer-screening on 12 December 2015. Google Scholar6. Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Zappa M, Nelen V, et al; ERSPC Investigators. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014;384:2027-35. [PMID: 25108889] doi:10.1016/S0140-6736(14)60525-0 CrossrefMedlineGoogle Scholar7. 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 Scholar8. Barry MJ, Wexler RM, Brackett CD, Sepucha KR, Simmons LH, Gerstein BS, et al. Responses to a decision aid on prostate cancer screening in primary care practices. Am J Prev Med. 2015;49:520-5. [PMID: 25960395] doi:10.1016/j.amepre.2015.03.002 CrossrefMedlineGoogle Scholar9. Heijnsdijk EA, de Carvalho TM, Auvinen A, Zappa M, Nelen V, Kwiatkowski M, et al. Cost-effectiveness of prostate cancer screening: a simulation study based on ERSPC data. J Natl Cancer Inst. 2015;107:366. [PMID: 25505238] doi:10.1093/jnci/dju366 CrossrefMedlineGoogle Scholar10. Centers for Medicare & Medicaid Services. Decision Memo for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) (CAG-00439N). Accessed at www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=274 on 12 December 2015. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Massachusetts General Hospital, Boston, Massachusetts, and University of Connecticut School of Medicine, Farmington, Connecticut.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-3025.Corresponding Author: Michael J. Barry, MD, General Medicine Division, Massachusetts General Hospital, 50 Staniford Street, Suite 802, Boston, MA 02114; e-mail, [email protected]harvard.edu.Current Author Addresses: Dr. Barry: General Medicine Division, Massachusetts General Hospital, 50 Staniford Street, Suite 802, Boston, MA 02114.Dr. Albertsen: Department of Surgery, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-3955.Author Contributions: Conception and design: M.J. Barry, P.C. Albertsen.Drafting of the article: M.J. Barry, P.C. Albertsen.Critical revision of the article for important intellectual content: P.C. Albertsen.Final approval of the article: M.J. Barry, P.C. Albertsen.This article was published at www.annals.org on 23 February 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 May 2016Volume 164, Issue 10Page: 687-688KeywordsCancer screeningCancer treatmentComputed axial tomographyDisclosureHealth careHealth care qualityHealth information technologyHospital medicineProstate cancerTestosterone ePublished: 23 February 2016 Issue Published: 17 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...