Posted: Tuesday, May 30, 2023
A survey study conducted by Brent S. Rose, MD, of the University of California, San Diego, and colleagues aimed to characterize factors associated with low-value prostate-specific antigen (PSA) screening among older males, since the U.S. Preventive Services Task Force guidelines advise against such screening in those older than age 69. The results of this study, published in JAMA Network Open, demonstrate the potential to inform interventions to disincentivize low-value screening.
“Older male respondents to the 2020 Behavioral Risk Factor Surveillance System survey were overscreened for prostate cancer despite the age cutoff for [PSA] screening recommended in national guidelines,” the investigators concluded. “Discussing the benefits of [PSA] testing with a clinician was associated with increased screening, underscoring the potential of clinician-level interventions to reduce overscreening in older males.”
This study collected data from 32,306 males who submitted responses to the national 2020 Behavioral Risk Factor Surveillance System. Participants were stratified into the following age groups: 70 to 74 years; 75 to 79 years; or 80 years or older.
Most individuals were White (87.6%), 4.3% were Black, and 3.4% were Hispanic. Of the total, 42.8% of respondents were between 70 and 74 years old, 28.4% were between 75 and 79 years old, and 28.9% were aged 80 or older. The rates of recent (within 2 years) PSA screenings were 55.3%, 52.1%, and 39.4% in the 70–74, 75–79, and ≥ 80 groups, respectively. PSA screening seemed to increase with higher annual income and educational level, and married respondents were screened more often than unmarried ones.
Discussion of PSA testing advantages with a clinician was significantly associated with increased recent screening (P < .001), and discussions of disadvantages did not seem to correlate with such screening. Of note, having a primary care physician, a post–high school education level, and an annual income of over $25,000 were associated with higher screening rates.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.