Prostate Cancer Incidence and PSA Testing Patterns in Relation to USPSTF Screening Recommendations

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• The US Preventive Services Task Force (USPSTF) issued recommendations in 2008 and 2012 advising against prostate-specific antigen (PSA)-based screening for prostate cancer.
• Previous data indicated a decrease in prostate cancer incidence among men aged 75 and older after the 2008 recommendation.

Purpose of the Study:

• To evaluate changes in stage-specific prostate cancer incidence and PSA screening rates after the 2008 and 2012 USPSTF recommendations.
• To analyze trends in prostate cancer diagnosis and screening behavior among men aged 50 and older.

Main Methods:

• An ecologic study analyzed age-standardized prostate cancer incidence data from 2005-2012 using 18 Surveillance, Epidemiology, and End Results (SEER) registries.
• National Health Interview Survey (NHIS) data from 2005, 2008, 2010, and 2013 were used to assess PSA screening rates in men aged 50 and older without a prior prostate cancer diagnosis.

Main Results:

• Prostate cancer incidence in men aged 50 and older decreased from 2008, with the largest drop observed between 2011 and 2012 (498.3 to 416.2 per 100,000).
• This decline was primarily in local/regional-stage disease and occurred across various age and racial groups.
• PSA screening rates among men aged 50 and older decreased by 18% between 2010 and 2013, following an initial 10% increase between 2005 and 2008.

Conclusions:

• Both early-stage prostate cancer incidence and PSA screening rates have decreased, coinciding with the 2012 USPSTF recommendation against routine screening.
• Further research is necessary to determine if these observed decreases are associated with future trends in prostate cancer mortality.