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Non-Recommended PSA-Based Screening in Older Men

This HEDIS Measure

Assesses whether men 70 years of age and older were screened unnecessarily for prostate cancer using prostate-specific antigen (PSA)-based screening.

So What?

Although prostate cancer is the most commonly diagnosed non-skin cancer among men in the U.S.,1,2 most cases are diagnosed at a later age, grow slowly and may not manifest as health problems during a patient’s lifetime.3,4 Research has shown that most men do not benefit from PSA-based screening, which can lead to unnecessary procedures with resultant harms. Complications due to biopsies and unnecessary treatment may constitute significant harms such as psychological effects, erectile dysfunction, urinary incontinence, serious cardiovascular events, deep-vein thrombosis and pulmonary embolism;5 therefore, clinical guidelines do not recommend routine PSA-based screening in most men.4,5

References

1.      Howlader, N., A.M. Noone, M. Krapcho, et al. 2015. “SEER Cancer Statistics Review, 1975-2012.” National Cancer Institute. Bethesda, MD. http://seer.cancer.gov/csr/1975_2012

2.      Li J., J.A. Djenaba, A. Soman, et al. 2012. “Recent Trends In Prostate Cancer Incidence by Age, Cancer Stage, and Grade, the United States, 2001–2007.” Prostate Cancer, Article ID 691380, 8 pages.

3.      Centers for Disease Control and Prevention (CDC). 2015. “Prostate Cancer.” http://www.cdc.gov/cancer/prostate/ (July 2015)

4.      Carter, H.B., P.C. Albertsen, M.J. Barry, et al. 2013. “Early detection of prostate cancer: AUA guideline.” J Urol 2013;190(2):419-26. doi: 10.1016/j.juro.2013.04.119. Epub 2013 May 6.

5.      Moyer, V.A. 2012. “Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement.” Ann Intern Med 157:120–34. Available from http://www.uspreventiveservicestaskforce.org/Page/Document/
RecommendationStatementFinal/prostate-cancer-screening. (June 2015.)

tables
Non-Recommended PSA-Based Screening in Older Men
  Commercial Medicaid Medicare
Year HMO PPO HMO HMO PPO

2015

--

--

--

32.2

34.5

 

*Lower rates signify better performance