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Public survey and survival data do not support recommendations to discontinue prostate-specific antigen screening in men at age 75.

Publication ,  Journal Article
Caire, AA; Sun, L; Robertson, CN; Polascik, TJ; Maloney, KE; George, DJ; Price, MM; Stackhouse, DA; Lack, BD; Albala, DM; Moul, JW
Published in: Urology
May 2010

OBJECTIVES: To evaluate the US Preventative Services Task Force (USPSTF) recommendation to discontinue prostate-specific antigen (PSA) screening at age 75. METHODS: Public survey: A cohort of 340 patients was surveyed at our PSA screening clinic and stratified by awareness of the recommendation and education level. Age (< 75, >or= 75), race, health insurance status, knowledge of prostate cancer, and opinion on screening discontinuation at age 75 was evaluated between groups. Disease risk and survival analysis: A cohort of 4196 men who underwent radical prostatectomy between 1988 and 2008 was stratified into age groups: < 65, 65-74, and >or= 75. Associations between clinicopathologic variables, disease risk, and survival were compared between age groups using univariate and multivariate analysis. RESULTS: Approximately 78% of men surveyed disagreed with the USPSTF recommendation. The number of men who disagreed was not significantly different between awareness groups (P = .962). Awareness of new screening guidelines showed a significant difference (P = .006) between education groups. Age >or= 75 years was predictive of high-risk disease based on D'Amico's criteria (odds ratio = 2.72, P = .003). Kaplan-Meier and Cox regression analyses showed an association of men aged >or= 75 years with higher rate of PSA recurrence, distant metastasis, and disease specific death compared with the age groups of < 65 and 65-74 (P <.05). CONCLUSIONS: Men presenting to our PSA screening clinic disagreed with discontinuation of screening at age 75. Men aged >or= 75 years had higher risk disease and poorer survival. The USPSTF recommendation was supported neither by public opinion nor disease risk and survival results.

Duke Scholars

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

May 2010

Volume

75

Issue

5

Start / End Page

1122 / 1127

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Survival Rate
  • Surveys and Questionnaires
  • Public Opinion
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Practice Guidelines as Topic
  • Male
  • Humans
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
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Caire, A. A., Sun, L., Robertson, C. N., Polascik, T. J., Maloney, K. E., George, D. J., … Moul, J. W. (2010). Public survey and survival data do not support recommendations to discontinue prostate-specific antigen screening in men at age 75. Urology, 75(5), 1122–1127. https://doi.org/10.1016/j.urology.2009.06.091
Caire, Arthur A., Leon Sun, Cary N. Robertson, Thomas J. Polascik, Kelly E. Maloney, Daniel J. George, Marva M. Price, et al. “Public survey and survival data do not support recommendations to discontinue prostate-specific antigen screening in men at age 75.Urology 75, no. 5 (May 2010): 1122–27. https://doi.org/10.1016/j.urology.2009.06.091.
Caire AA, Sun L, Robertson CN, Polascik TJ, Maloney KE, George DJ, et al. Public survey and survival data do not support recommendations to discontinue prostate-specific antigen screening in men at age 75. Urology. 2010 May;75(5):1122–7.
Caire, Arthur A., et al. “Public survey and survival data do not support recommendations to discontinue prostate-specific antigen screening in men at age 75.Urology, vol. 75, no. 5, May 2010, pp. 1122–27. Pubmed, doi:10.1016/j.urology.2009.06.091.
Caire AA, Sun L, Robertson CN, Polascik TJ, Maloney KE, George DJ, Price MM, Stackhouse DA, Lack BD, Albala DM, Moul JW. Public survey and survival data do not support recommendations to discontinue prostate-specific antigen screening in men at age 75. Urology. 2010 May;75(5):1122–1127.
Journal cover image

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

May 2010

Volume

75

Issue

5

Start / End Page

1122 / 1127

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Survival Rate
  • Surveys and Questionnaires
  • Public Opinion
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Practice Guidelines as Topic
  • Male
  • Humans
  • Aged