Prostate-specific antigen screening in elderly men

Although the efficacy of prostate-specific antigen (PSA) screening for prostate cancer has not been established, it is widely used. However, despite the overall controversy regarding PSA screening, there has been general agreement that elderly men (i.e., those aged 75 years or older) should not be screened. By using a nationally representative sample of 7889 men who participated in the 2000 National Health Interview Survey, we found that the rate of PSA screening among men aged 75 or older was 32.5% (95% confidence interval [CI] = 28.8% to 36.1%), which was greater than that of fecal occult blood screening among men of the same age (22.8%, 95% CI = 19.2% to 26.4%) and was comparable with that of annual Pap smear screening among women aged 75 years or older (29.0%, 95% CI = 26.6% to 31.3%). Among screened elderly men, 88.4% (95% CI = 82.3% to 92.6%) reported that their doctor first suggested screening and 66.5% (95% CI = 59.7% to 73.3%) reported that the risks and benefits of screening were discussed before screening. We conclude that strategies are needed to increase understanding of the risks and benefits of PSA screening among elderly men.