Presentation Authors: Varun Talanki*, Qinjie Wang, William Berg, Howard Adler, Stony Brook, NY
Introduction: The 2008 United States Preventive Services Task Force (USPSTF) guidelines recommended against screening patients older than 75 years with PSA testing. The recommendation in 2012 further expanded these criteria to recommend against screening for prostate cancer based on PSA in all patients. It remains unclear how these changes impact public perception and participation in screening programs. We sought to compare prostate cancer screening participation before and after the 2012 USPSTF guidelines.
Methods: We conduct a state funded, free to participants, prostate cancer screening program. All participants present with the desire to screen for prostate cancer with PSA. Our cohort consisted of 7, 950 voluntary screening encounters at various sites in our county. These sites consisted of our outpatient clinic, community health centers, churches, fire and police departments. Patients were divided into two groups and compared based on the major guideline change in May 2012: 1) June 2008 to May 2012; 2) June 2012 to May 2016.
Results: Total patient encounters declined from 4,545 to 3,405 after the 2012 USPSTF screening guidelines. New patient screenings declined from 2,662 to 1,126. An increased number of patients reported a positive family history of prostate and/or breast cancer. The percentage of participants with a smoking history decreased from 51.33% to 46.33%. We found no significant difference in marital status, IPSS, PSA.
Conclusions: Our study is the first to date reviewing PSA test participation after the 2012 USPSTF guidelines in a cohort of participants primarily presenting for prostate cancer screening. In our cohort we demonstrate a decrease in prostate cancer screening after the 2012 USPSTF recommendations. How this decrease in PSA testing will affect prostate cancer specific mortality is unknown. The guidelines in 2018 were updated to recommend individualized, patient-specific routine PSA testing in patients aged 55 to 69. How this revision to the guidelines will affect prostate cancer screening remains to be seen. Community education in this area is essential and the urologic community must lead public discourse on prostate cancer screening.