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PSA testing in office-based clinics: are we testing as much as we think?
Hector M González1, Brady West, Willie Underwood
1Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48104-2029, USA.
Journal of the American College of Surgeons
|November 29, 2005
Summary
Routine prostate-specific antigen (PSA) testing was used in 10.2% of physician visits for prostate-cancer-free men. Men in their 70s were more likely to receive a PSA test, while those with comorbidities were less likely.
Area of Science:
- Urology
- Public Health
- Health Services Research
Background:
- Concerns exist regarding overuse and potential harm from routine prostate-specific antigen (PSA) testing.
- Self-report studies indicate widespread PSA test utilization.
- This study investigates PSA testing in a national sample of men without prostate cancer.
Purpose of the Study:
- To examine the utilization patterns of PSA testing during physician office visits.
- Focus on prostate-cancer-free men aged 40 and older.
Main Methods:
- Analysis of the 2000 National Ambulatory Medical Care Survey data.
- Bivariate and multivariate logistic regression models were employed.
- The study included 2,709 office visits by men aged 40+ without prostate cancer.
Main Results:
- Prostate-specific antigen (PSA) testing occurred in 10.2% of analyzed visits.
- Men in their 70s demonstrated significantly higher odds of receiving a PSA test (OR, 1.60).
- Men with multiple medical comorbidities showed significantly lower odds of receiving a PSA test (OR, 0.28).
Conclusions:
- Observed PSA testing rates are lower than previously reported in literature.
- Further research using administrative data is needed to understand PSA testing's impact.
- Impact on healthcare costs, prostate cancer incidence, and mortality requires additional investigation.