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PD44-02 TRENDS IN PSA UTILIZATION BY PRIMARY CARE PHYSICIANS: IMPACT OF THE USPSTF RECOMMENDATION

2015; Lippincott Williams & Wilkins; Volume: 193; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2015.02.2548

1527-3792

Ryan P. Werntz, Ann Martinez Acevedo, Michael J. Conlin, Christopher L. Amling,

Cervical Cancer and HPV Research

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 2015PD44-02 TRENDS IN PSA UTILIZATION BY PRIMARY CARE PHYSICIANS: IMPACT OF THE USPSTF RECOMMENDATION Ryan Werntz, Ann Martinez Acevedo, Michael Conlin, and Christopher Amling Ryan WerntzRyan Werntz More articles by this author , Ann Martinez AcevedoAnn Martinez Acevedo More articles by this author , Michael ConlinMichael Conlin More articles by this author , and Christopher AmlingChristopher Amling More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2548AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The controversy surrounding the value of PSA screening for early detection of prostate cancer was stirred further by the USPSTF recommendation against PSA testing in May 2012. This recommendation was based in large part upon an analysis by the Pacific Northwest Evidence-based Practice Center at our institution, an academic medical center with a strong primary care focus. We assess trends in PSA utilization by primary care providers at our institution before and after the USPSTF recommendation against PSA screening. METHODS Patients were identified utilizing our institutional electronic data warehouse. All were men over age 40 years seen as new patients at OSHU's Family Medicine or Internal Medicine clinics over a six year period (1/20008 to 12/2013). Men with a history of prostate cancer were excluded from the analysis. PSA testing frequencies were compared before and after the 5/2012 USPSTF recommendation, and stratified according to patient age groups by decade (40-49, 50-59, 60-69 and ≥70 years). Differences in PSA testing frequencies before and after 5/2012 were tested for significance using the Pearson chi-squared test. RESULTS A total of 12,345 men were seen as a new patient appointment over this period. A PSA test was ordered in conjunction with this visit in 1,464 (14%) men. Overall, 1241 (14%) received a PSA test before 5/2012 and 223 (7%) after this time (p<0.0001). While there was no significant difference in PSA testing frequency before and after 5/2012 in men aged 40-49 years (4.2% versus 4.4%) and over age 70 years (10.2% versus 9.3%), there were significant decreases in PSA utilization in men aged 50-59 years (19.2% versus 8.5%, p<0.0001) and 60-69 years (19.3% versus 7.7%, p<0.0001). Considering men aged 50-70 years as a group, testing frequency decreased from 19.3% before to 8.2% after the USPSTF recommendation (p<0.0001). BPH or LUTS was a noted diagnosis in 3.6% of new patients seen, yet only 36% with this diagnosis had a PSA obtained in conjunction with their visit. CONCLUSIONS PSA testing by primary care physicians has decreased significantly since the USPSTF recommendation against PSA screening in 2012. The most significant decreases in PSA utilization were seen in men aged 50-70 years, men who may be most likely to benefit from screening, while PSA testing remained the same in men over age 70 years. While a PSA test in men with BPH and LUTS was more likely, only a third of these patients were tested, suggesting underutilization of PSA in this symptomatic group of men. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e897 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryan Werntz More articles by this author Ann Martinez Acevedo More articles by this author Michael Conlin More articles by this author Christopher Amling More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...