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
Results – National Averages
Non-Recommended PSA-Based Screening in Older Men
| Measure Year | Medicare HMO | Medicare PPO |
|---|---|---|
| 2022 | 29.2 | 32.2 |
| 2021 | 29 | 31.8 |
| 2020 | 26.2 | 29.8 |
| 2019 | § | § |
| 2018 | 28.6 | 31.5 |
| 2017 | 31 | 33.5 |
| 2016 | 31.3 | 34.5 |
| 2015 | 32.2 | 34.5 |
§ Not available due to CMS suspension of data reporting during COVID-19 pandemic.
This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.
Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via my.ncqa.org for analysis that accounts for trend breaks.
References
- 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.