Contemporary National Trends of Prostate Cancer Screening Among Privately Insured Men in the United States

Simon P. Kim, Robert Jeffrey Karnes, Cary P. Gross, Neal J. Meropol, Holly Van Houten, Robert Abouassaly, Nilay D Shah

Research output: Contribution to journalArticle

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Abstract

Objective To assess the possible impact of changes to the clinical guidelines from the US Preventive Services Task Force recommendations in 2012 on the national trends of prostate-specific antigen (PSA) screening and identify patient characteristics associated with PSA screening from a large private insurance database. Materials and Methods We conducted a retrospective cohort study of men between 40 and 80 years of age who underwent PSA screening for prostate cancer from 2008 to 2013 in a population-based cohort of privately insured patients. Unadjusted and adjusted rates were calculated using member-years and reported per 1000 member-years. Results Rates of PSA screening remained stable from 190.4 per 1000 member-years in 2008 to 196.4 in 2013 (P = .66). From 2008 to 2013, PSA screening did not change for patients aged 50-59 (236.5 to 241.1 per 1000 member-years; P = .78), 60-64 (284.1 to 288.3 per 1000 member-years; P = .77), 65-69 (250.6 to 248.0 per 1000 member-years; P = .56), and 70-74 (266.4 to 280.3 per 1000 member-years; P = .17). However, patients ≥75 years had marked decrease in the rate of PSA screening from 201.5 to 124.1 per 1000 member-years (P = .04). Across different racial groups, PSA screening rates remain unchanged over time irrespective of age. Conclusion Among this population-based cohort of privately insured men, we found little effect on PSA screening from changes to the US Preventive Services Task Force clinical practice guidelines. However, the rates of PSA screening were much lower among older men (>75 years). Further research is needed to assess the impact of the new guidelines on prostate cancer incidence and survival.

Original languageEnglish (US)
Pages (from-to)111-117
Number of pages7
JournalUrology
Volume97
DOIs
StatePublished - Nov 1 2016

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Prostate-Specific Antigen
Early Detection of Cancer
Prostatic Neoplasms
Advisory Committees
Guidelines
Insurance
Practice Guidelines
Population
Cohort Studies
Retrospective Studies
Databases
Survival
Incidence
Research

ASJC Scopus subject areas

  • Urology

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Contemporary National Trends of Prostate Cancer Screening Among Privately Insured Men in the United States. / Kim, Simon P.; Karnes, Robert Jeffrey; Gross, Cary P.; Meropol, Neal J.; Van Houten, Holly; Abouassaly, Robert; Shah, Nilay D.

In: Urology, Vol. 97, 01.11.2016, p. 111-117.

Research output: Contribution to journalArticle

Kim, Simon P. ; Karnes, Robert Jeffrey ; Gross, Cary P. ; Meropol, Neal J. ; Van Houten, Holly ; Abouassaly, Robert ; Shah, Nilay D. / Contemporary National Trends of Prostate Cancer Screening Among Privately Insured Men in the United States. In: Urology. 2016 ; Vol. 97. pp. 111-117.
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abstract = "Objective To assess the possible impact of changes to the clinical guidelines from the US Preventive Services Task Force recommendations in 2012 on the national trends of prostate-specific antigen (PSA) screening and identify patient characteristics associated with PSA screening from a large private insurance database. Materials and Methods We conducted a retrospective cohort study of men between 40 and 80 years of age who underwent PSA screening for prostate cancer from 2008 to 2013 in a population-based cohort of privately insured patients. Unadjusted and adjusted rates were calculated using member-years and reported per 1000 member-years. Results Rates of PSA screening remained stable from 190.4 per 1000 member-years in 2008 to 196.4 in 2013 (P = .66). From 2008 to 2013, PSA screening did not change for patients aged 50-59 (236.5 to 241.1 per 1000 member-years; P = .78), 60-64 (284.1 to 288.3 per 1000 member-years; P = .77), 65-69 (250.6 to 248.0 per 1000 member-years; P = .56), and 70-74 (266.4 to 280.3 per 1000 member-years; P = .17). However, patients ≥75 years had marked decrease in the rate of PSA screening from 201.5 to 124.1 per 1000 member-years (P = .04). Across different racial groups, PSA screening rates remain unchanged over time irrespective of age. Conclusion Among this population-based cohort of privately insured men, we found little effect on PSA screening from changes to the US Preventive Services Task Force clinical practice guidelines. However, the rates of PSA screening were much lower among older men (>75 years). Further research is needed to assess the impact of the new guidelines on prostate cancer incidence and survival.",
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N2 - Objective To assess the possible impact of changes to the clinical guidelines from the US Preventive Services Task Force recommendations in 2012 on the national trends of prostate-specific antigen (PSA) screening and identify patient characteristics associated with PSA screening from a large private insurance database. Materials and Methods We conducted a retrospective cohort study of men between 40 and 80 years of age who underwent PSA screening for prostate cancer from 2008 to 2013 in a population-based cohort of privately insured patients. Unadjusted and adjusted rates were calculated using member-years and reported per 1000 member-years. Results Rates of PSA screening remained stable from 190.4 per 1000 member-years in 2008 to 196.4 in 2013 (P = .66). From 2008 to 2013, PSA screening did not change for patients aged 50-59 (236.5 to 241.1 per 1000 member-years; P = .78), 60-64 (284.1 to 288.3 per 1000 member-years; P = .77), 65-69 (250.6 to 248.0 per 1000 member-years; P = .56), and 70-74 (266.4 to 280.3 per 1000 member-years; P = .17). However, patients ≥75 years had marked decrease in the rate of PSA screening from 201.5 to 124.1 per 1000 member-years (P = .04). Across different racial groups, PSA screening rates remain unchanged over time irrespective of age. Conclusion Among this population-based cohort of privately insured men, we found little effect on PSA screening from changes to the US Preventive Services Task Force clinical practice guidelines. However, the rates of PSA screening were much lower among older men (>75 years). Further research is needed to assess the impact of the new guidelines on prostate cancer incidence and survival.

AB - Objective To assess the possible impact of changes to the clinical guidelines from the US Preventive Services Task Force recommendations in 2012 on the national trends of prostate-specific antigen (PSA) screening and identify patient characteristics associated with PSA screening from a large private insurance database. Materials and Methods We conducted a retrospective cohort study of men between 40 and 80 years of age who underwent PSA screening for prostate cancer from 2008 to 2013 in a population-based cohort of privately insured patients. Unadjusted and adjusted rates were calculated using member-years and reported per 1000 member-years. Results Rates of PSA screening remained stable from 190.4 per 1000 member-years in 2008 to 196.4 in 2013 (P = .66). From 2008 to 2013, PSA screening did not change for patients aged 50-59 (236.5 to 241.1 per 1000 member-years; P = .78), 60-64 (284.1 to 288.3 per 1000 member-years; P = .77), 65-69 (250.6 to 248.0 per 1000 member-years; P = .56), and 70-74 (266.4 to 280.3 per 1000 member-years; P = .17). However, patients ≥75 years had marked decrease in the rate of PSA screening from 201.5 to 124.1 per 1000 member-years (P = .04). Across different racial groups, PSA screening rates remain unchanged over time irrespective of age. Conclusion Among this population-based cohort of privately insured men, we found little effect on PSA screening from changes to the US Preventive Services Task Force clinical practice guidelines. However, the rates of PSA screening were much lower among older men (>75 years). Further research is needed to assess the impact of the new guidelines on prostate cancer incidence and survival.

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