Age, life expectancy influence termination of PSA screening

Craig E. Pollack, M.D., M.H.S., from the Johns Hopkins School of Medicine in Baltimore, and colleagues surveyed 125 primary providers from a large, university-affiliated primary care practice regarding their current screening practices, factors that influence their decision to discontinue screening, and barriers to discontinuing screening.

The researchers found that 59.3 percent of the primary care providers took both age and life expectancy into account in their decisions to discontinue PSA screening, compared with 12.2 percent who did not consider either. Provider characteristics or practice styles were not associated with taking patient age and life expectancy into account. The majority (66.4 percent) of providers reported difficulty in assessing life expectancy and they differed in the age at which they typically stopped screening patients. Patient expectation and time constraints were the most frequently cited barriers to discontinuing PSA screening, cited 74.4 and 66.4 percent of the time, respectively.

"Although age and life expectancy often figured prominently in decisions to use screening, providers faced multiple barriers to discontinuing routine PSA screening," the authors write.

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