PSA Testing Use and Prostate Cancer Diagnostic Stage After the 2012 U.S. Preventive Services Task Force Guideline Changes

Magnani, Christopher J.; Li, Kevin; Seto, Tina; McDonald, Kathryn M; Blayney, Douglas W.; Brooks, James D.; Hernandez‐Boussard, Tina

doi:10.6004/jnccn.2018.7274

Cited by 22 publications

(22 citation statements)

References 38 publications

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“…Not surprisingly, they found a decrease in Google searches about PSA screening after the US Preventive Services Task Force (USPSTF) issued a Grade D recommendation against screening. This corresponds with observed trends of decreased PSA screening in the population . Notably, the volume of Google searches about PSA screening rebounded after the USPSTF changed to a Grade C recommendation for shared decision‐making about screening.…”

supporting

confidence: 70%

Does Dr Google give good advice about prostate cancer?

2019

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supporting

confidence: 70%

Does Dr Google give good advice about prostate cancer?

2019

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“… 4 In studies that examined screening from 2013 to 2016, estimates ranged between 9.8 and 18.6% of eligible men. 19 , 20 While these proportions of Grade D prostate cancer screening are higher than the 4.2% of eligible visits in our study, it is important to note that our units of analysis were visits among Medicare beneficiaries seeking care rather than all Medicare beneficiaries. Therefore, the differences in screening may be due to differences in levels of analysis (visit-level versus patient-level) and the number of years used to derive estimates.…”

Section: Discussionmentioning

confidence: 58%

The Utilization and Costs of Grade D USPSTF Services in Medicare, 2007–2016

et al. 2021

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Background Low-value care, or patient care that offers no net benefit in specific clinical scenarios, is costly and often associated with patient harm. The US Preventive Services Task Force (USPSTF) Grade D recommendations represent one of the most scientifically sound and frequently delivered groups of low-value services, but a more contemporary measurement of the utilization and spending for Grade D services beyond the small number of previously studied measures is needed. Objective To estimate utilization and costs of seven USPSTF Grade D services among US Medicare beneficiaries. Design We conducted a cross-sectional study of data from the National Ambulatory Medical Care Survey (NAMCS) from 2007 to 2016 to identify instances of Grade D services. Setting/Participants NAMCS is a nationally representative survey of US ambulatory visits at non-federal and non-hospital-based offices that uses a multistage probability sampling design. We included all visits by Medicare enrollees, which included traditional fee-for-service, Medicare Advantage, supplemental coverage, and dual-eligible Medicare-Medicaid enrollees. Main Measures We measured annual utilization of seven Grade D services among adult Medicare patients, using inclusion and exclusion criteria from prior studies and the USPSTF recommendations. We calculated annual costs by multiplying annual utilization counts by mean per-unit costs of services using publicly available sources. Key Results During the study period, we identified 95,121 unweighted Medicare patient visits, representing approximately 2.4 billion visits. Each year, these seven Grade D services were utilized 31.1 million times for Medicare beneficiaries and cost $477,891,886. Three services—screening for asymptomatic bacteriuria, vitamin D supplements for fracture prevention, and colorectal cancer screening for adults over 85 years—comprised $322,382,772, or two-thirds of the annual costs of the Grade D services measured in this study. Conclusions US Medicare beneficiaries frequently received a group of rigorously defined and costly low-value preventive services. Spending on low-value preventive care concentrated among a small subset of measures, representing important opportunities to safely lower US health care spending while improving the quality of care. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-06784-8.

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“…Prostate cancer is often detected by prostate-specific antigen screening when it is asymptomatic, and there has been a decrease in prostate cancer screening in the US general population since 2012 reflecting changing guidelines. 29,30 Two possible explanations for the deficit of prostate cancer among KTRs both J o u r n a l P r e -p r o o f relate to screening: either candidates for kidney transplantation are screened more frequently than men in the general population, so that there are fewer subsequent prostate cancers remaining to be diagnosed after transplantation, or KTRs are screened less frequently following transplantation than men in the general population, so that some cancers are missed. For both explanations, growing differences in screening between KTRs and the general population could then explain the decreasing calendar trend in prostate cancer incidence.…”

Section: Discussionmentioning

confidence: 99%