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Increasing the value of PSA through improved implementation.

Suzanne Lange1, Brock O'Neil1

  • 1Division of Urology, Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.

Urologic Oncology
|November 9, 2021
PubMed
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Prostate-specific antigen (PSA) testing contributes to healthcare waste. Smarter testing strategies are needed to improve the value of PSA screening for prostate cancer, reducing harms and increasing benefits.

Area of Science:

  • Health Economics
  • Oncology
  • Medical Diagnostics

Background:

  • Low-value healthcare services, including frequent, low-cost tests like prostate-specific antigen (PSA), generate billions in annual US healthcare waste.
  • Prostate cancer screening using PSA has faced fluctuating recommendations due to unclear benefits and a high risk of overtreatment, despite declining mortality rates.

Purpose of the Study:

  • To address the inefficiency of current healthcare delivery by improving the value of prostate-specific antigen (PSA) testing.
  • To explore strategies for optimizing PSA testing to mitigate harms and enhance benefits in prostate cancer screening.

Main Methods:

  • Analysis of healthcare spending related to low-value testing.
  • Review of prostate-specific antigen (PSA) testing protocols and their impact on prostate cancer outcomes.
Keywords:
Decision support systems, clinicalDelivery of health careEarly detection of cancerProstate-specific antigen

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  • Evaluation of potential benefits and harms associated with different PSA screening strategies.

    • Main Results:

    • High-frequency, low-cost testing, specifically PSA, is a significant driver of healthcare inefficiency and waste.
    • Uncertainty regarding the benefits of PSA screening and the risk of overtreatment have impacted its perceived value.
    • Potential exists to improve the value of PSA testing through strategic implementation.

    Conclusions:

    • Optimizing prostate-specific antigen (PSA) testing strategies is crucial for reducing healthcare waste.
    • Smarter implementation of PSA screening can enhance its benefits while minimizing associated harms.
    • Improving the value of PSA testing is essential for efficient prostate cancer management.