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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Caire, AA; Sun, L; Robertson, CN; Polascik, TJ; Maloney, KE; George, DJ; Price, MM; Stackhouse, DA; Lack, BD; Albala, DM; Moul, JW

Published Date

  • May 2010

Published In

Volume / Issue

  • 75 / 5

Start / End Page

  • 1122 - 1127

PubMed ID

  • 19815259

Pubmed Central ID

  • 19815259

Electronic International Standard Serial Number (EISSN)

  • 1527-9995

Digital Object Identifier (DOI)

  • 10.1016/j.urology.2009.06.091

Language

  • eng

Conference Location

  • United States