Assess whether men 70 years of age and older were screened unnecessarily for prostate cancer using prostate-specific antigen (PSA)-based screening.
Why it Matters
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. They grow slowly and may not manifest as health problems during a patient’s lifetime.3,4
Research shows that most men do not benefit from PSA-based screening, which can leas to unnecessary procedures with resultant harms. Complications due to biopsies and unnecessary treatment may constitute significant harms. This includes 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
Non-Recommended PSA-Based Screening in Older Men
|Year||Medicare HMO||Medicare PPO|
- Howlander., 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
- 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.
- Centers for Disease Control and Prevention (CDC). 2015. “Prostate Cancer.” http://www.cdc.gov/cancer/prostate/ (July 2015)
- 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.
- Moyer, V.A. 2012. “Screening for Prostate Cancer. U.S. Preventative Services Task Force Recommendation Statement.” Ann Intern Med 157:120-34.