PSA Screening Continues Despite USPSTF Guidance

Back in May of 2012, the United States Preventive Services Task Force (USPSTF) examined the use of PSA screening and concluded that the harms associated with the overtreatment of prostate cancer outweighed the benefits of its early detection. The USPSTF issued a “grade D” recommendation, which is a recommendation against the use of PSA-based screening for men of all ages.

Researchers at the University of Texas Southwestern Medical Center in Dallas used electronic medical records at their institution to analyze real-world data on PSA ordering and referral practices between January 2010 and July 2015. They reviewed 275,784 unique ambulatory visits for men and found 54,684 evaluable PSA orders. Primary care providers ordered 17,315 PSA tests and 858 urology referrals.

Over the 5-year study period, the number of PSA tests per ambulatory visit, the number of referrals per ambulatory visit, the age at the time of the urology referral, and the proportion of PSA tests performed outside the recommended age range did not significantly change.

The researchers concluded that despite the USPSTF recommendation in 2012 to avoid routine PSA testing, clinicians at the institution studied continued to use the PSA as a screening tool for prostate cancer. Although these results cannot be generalized to other healthcare institutions, their findings suggest that clinicians at other institutions also may be continuing to order this test.

Hutchinson R, Akhtar A, Haridas J, et al. Testing and referral patterns in the years surrounding the US Preventive Services Task Force recommendation against prostate-specific antigen screening [published online ahead of print September 22, 2016]. Cancer.