Primary care physician PSA screening practices before and after the final U.S. Preventive Services Task Force recommendation

Cohn, Joshua A.; Wang, Chihsiung E.; Lakeman, Justin C.; Silverstein, Jonathan C.; Brendler, Charles B.; Novakovic, Kristian; McGuire, Michael; Helfand, Brian T.

doi:10.1016/j.urolonc.2013.04.013

Cited by 78 publications

(63 citation statements)

References 27 publications

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“…Numerous studies have evaluated the temporal associations of publishing screening guidelines and clinical trial results on screening practices and attitudes (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). However, most studies focused on the impact of the 2008 USPSTF guidelines.…”

Section: Introductionmentioning

confidence: 99%

Trends in United States Prostate Cancer Incidence Rates by Age and Stage, 1995–2012

Hoffman¹,

Meisner

Arap

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: The advent of PSA testing in the late 1980s substantially increased prostate cancer incidence rates. Concerns about overscreening and overdiagnosis subsequently led professional guidelines (circa 2000 and later) to recommend against routine PSA testing. We evaluated trends in prostate cancer incidence, including late-stage diagnoses, from 1995 through 2012.Methods: We used joinpoint regression analyses to evaluate all-, localized/regional-, and distant-stage prostate cancer incidence trends based on Surveillance, Epidemiology, and End Results (SEER) data. We stratified analyses by age (50-69, 70þ). We reported incidence trends as annual percent change (APC).Results: Overall age-adjusted incidence rates for localized/ regional stage prostate cancer have been declining since 2001, sharply from 2010 to 2012 [APC, À13.1; 95% confidence inter-

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Section: Introductionmentioning

confidence: 99%

Trends in United States Prostate Cancer Incidence Rates by Age and Stage, 1995–2012

Hoffman¹,

Meisner

Arap

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Our findings are in keeping with an American survey of primary care physicians by Cohn et al which found the greatest decline in screening rates among the youngest and oldest patients following the USPSTF. 17 Although practices were more in keeping with national urological association guidelines, respondents were more familiar with the CTFPHC and USPSTF (Figure 6). Publications by the CUA, AUA, and Prostate Cancer Canada were less well recognized.…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer screening among family physicians in Ontario: An update on attitudes and current practice

Akerman

Allard

Tajzler

et al. 2017

CUAJ

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Introduction: This study serves as an update of prostate cancer screening practices among family physicians in Ontario, Canada. Since this population was first surveyed in 2010, the Canadian Task Force on Preventive Health Care (CTFPHC) and the United States Preventive Services Task Force (USPSTF) released recommendations against prostate cancer screening. Methods: An online survey was developed through input from urologists and family practitioners. It was distributed via email to all members of the Ontario Medical Association's Section on General and Family practice (11 657 family physicians). A reminder email was sent at two weeks and the survey remained active for one month. Results: A total of 1880 family physicians completed surveys (response rate 16.1%). Overall, 80.4% offered prostate cancer screening compared to 91.7% when surveyed in 2010. Physicians new to practice (two years or less) were the most likely to not offer screening (24.6%). A combination of digital rectal exam (DRE) and prostate-specific antigen (PSA) remained the most common form of screening (58.3%). Following the release of the CTFPHC recommendations, 45.6% of respondents said they now screen fewer patients. Participants were less familiar with national urological society guidelines compared to task force recommendations. The majority (72.6%) of respondents feel PSA screening leads to overdiagnosis and treatment. Those surveyed remained split with respect to PSA utility. Conclusions: Data suggest a decline in screening practices since 2010, with newer graduates less likely to offer screening. CFTPHC and USPSTF recommendations had the greatest impact on clinical practice. Those surveyed were divided with respect to PSA utility. Some additional considerations to PSA screening in the primary care setting, including patient-driven factors, were not captured by our concise survey.

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“…Cohn et al showed a significant decrease in PSA screening by primary care physicians comparing the six-month periods pre-and post-release of the USPSTF guideline. 7 Jemal et al reported decreased PSA screening and decreased numbers of early-stage cancers being diagnosed in men greater than 50 years old in the year following release of the USPSTF guideline. 8 Barocas et al identified a 28% reduction in the incident diagnosis of prostate cancer in the year after the release of the USPSTF guideline.…”

Section: Our Interpretationmentioning

confidence: 99%

“…5,6 There have been several recent publications, mostly from the U.S., examining the downstream effects of the release of these guidelines on the rate and characteristics of prostate cancer diagnoses. [7][8][9][10][11][12][13] We are confident that most jurisdictions in Canada have been similarly affected and as such we wanted to review our community hospital-based experience with PSA screening and subsequent rate of transrectal ultrasound prostate biopsy (TRUSPB) and radical prostatectomies (RP) to quantify these trends locally. Over the same time period, we queried our pathology database for all TRUSPB and RP cases.…”

Section: Introductionmentioning

confidence: 99%

Implications of prostate-specific antigen screening guidelines on clinical practice at a Canadian regional community hospital

Webster

Lau

Newell

2017

CUAJ

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Primary care physician PSA screening practices before and after the final U.S. Preventive Services Task Force recommendation

Cited by 78 publications

References 27 publications

Trends in United States Prostate Cancer Incidence Rates by Age and Stage, 1995–2012

Trends in United States Prostate Cancer Incidence Rates by Age and Stage, 1995–2012

Prostate cancer screening among family physicians in Ontario: An update on attitudes and current practice

Implications of prostate-specific antigen screening guidelines on clinical practice at a Canadian regional community hospital

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