For prostate cancer screening, guidelines have little effect on clinical practice

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According to a new study published online in The Journal of the American Medical Association Internal Medicine, guidelines recommending that clinicians should not routinely screen elderly men for prostate cancer have had a minimal effect on practice. Researchers from Henry Ford Hospital in Detroit, Michigan, sought to find out whether a change in prostate screening guidelines by the U.S. Preventive Services Task Force (USPSTF) had altered practice in the last 3 years since the USPSTF recommended against routine prostate specific antigen (PSA) testing in any age group.


By using the 2012 Behavioral Risk Factor Surveillance System, the researchers examined which factors influence whether a patient is screened for prostate cancer, including access to health care, age, education, ethnicity/race, geographic location, income, insurance status, and marital status. They found that access to regular health care was strongly associated with increased rates of PSA screening.


In addition, they found an association between screening and an income greater than $75,000, higher education, health insurance, and an age between 70 and 74. Surprisingly, Hawaii has double the rate of PSA screening compared with New Hampshire.


The researchers suggest that the USPSTF guidelines have little effect on clinical practice.

Doctors steer prostate cancer treatment choices
Guidelines recommending not routinely screening have had a minimal effect on practice.

The effect of guidelines recommending that elderly men should not be routinely screened for prostate cancer "has been minimal at best," according to a new study led by researchers at Henry Ford Hospital.

The study, published as a research letter online in JAMA Internal Medicine, focused on the use of PSA - prostate-specific antigen - to test for prostate cancer. "We found that the effect of the guidelines recommending against the routine screening of elderly men in particular has been minimal at best," says Jesse Sammon, D.O., a researcher at Henry Ford's Vattikuti Urology Institute and lead author of the study.

The researchers found an estimated 17 million men age 50 or older without a history of prostate cancer or prostate problems who reported undergoing PSA screening. Though credited with a significant improvement in 5-year cancer survival rates during the first decade after the FDA approved PSA testing of men without symptoms, its use for routine screening is controversial.

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