Impact of 2012 USPSTF guideline against PSA screening explored
John S. Banerji, M.D., from the Virginia Mason Medical Center in Seattle, and colleagues reviewed data from a prospective database of patients undergoing prostate needle biopsies from 2004 to 2014. The authors compared patients seen before and after the USPSTF recommendations.
The researchers found that, compared with the 1,416 patients in the pre-USPSTF group, the 310 patients in the post-USPSTF group had a higher prostate-specific antigen (P < 0.001); they were also more likely to be diagnosed with higher clinical stage (2b, P = 0.003; 2c-3a, P = 0.027) and D'Amico high-risk prostate cancer (P = 0.036), with an adjusted relative risk of 1.25 for high-risk prostate cancer. Similar results were seen when the pre-USPSTF group was limited to 448 patients seen in the 30 months before the draft guidelines. There was a 31 percent decrease in the absolute number of biopsies performed, with most of the decrease occurring in the detection of intermediate-risk tumors.
"Future focus on informed application of screening techniques may prevent the reversal of decades of improvement in the prostate cancer mortality rate," the authors write.
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