NEW YORK — How did the 2012 U.S. Preventive Services Task Force recommendation against the prostate specific antigen screening for prostate cancer affect practice at the VHA?
A study published in the Journal of the National Cancer Institute looked at PSA screening trends in the VHA before and after the USPSTF recommendation, also seeking to determine if PSA screening was more likely to be ordered based on a veteran’s race or age.1
Researchers used the VA Corporate Data Warehouse to create 10 annual groups of PSA-eligible men covering 2009-2018, identifying all PSA tests performed in the VHA to determine yearly rates of PSA screening.
Results indicated that the overall rate of PSA testing in the VA decreased from 63.3% in 2009 to 51.2% in 2018 (p< 0.001). The study team pointed out that PSA screening rates also varied significantly by age group during the study period, with men aged 70-80 having the highest initial rate and greatest decline (70.6% in 2009 to 48.4% in 2018, p< 0.001). A smaller decline was documented in men aged 55-69 (65.2% in 2009 to 58.9% in 2018, p< 0.001) while the youngest cohort, aged 40-54, had an increase in PSA screening (26.2% in 2009 to 37.8 in 2018, p< 0.001).
“In this analysis of PSA screening rates among veterans before and after the 2012 USPSTF recommendation against screening, we found that overall PSA screening decreased only modestly, continuing for more than half of the men in our study,” the authors concluded. “Veterans of different races had similar screening rates, suggesting that VA care may minimize racial disparities. Veterans of varying age experienced significantly different trends in PSA screening.”
- Becker DJ, Rude T, Walter D, Wang C, et al. The Association of Veterans’ PSA Screening Rates with Changes in USPSTF Recommendations. J Natl Cancer Inst. 2020 Aug 14:djaa120. doi: 10.1093/jnci/djaa120. Epub ahead of print. PMID: 32797212.