National trends in prostate cancer screening among older American men with limited 9‐year life expectancies: Evidence of an increased need for shared decision making. Issue 10 (12th February 2014)

• Record Type: Journal Article
• Authors: Drazer, Michael W.; Prasad, Sandip M.; Huo, Dezheng; Schonberg, Mara A.; Dale, William; Szmulewitz, Russell Z.; Eggener, Scott E.
• Is Part Of: Cancer. Volume 120:Issue 10(2014)
• Page Start: 1491
• Page End: 1498
• Publication Date: 2014-02-12
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28600
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr28600-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Prostate‐specific antigen (PSA) screening for prostate cancer remains controversial. Most groups recommend informed decision making for men with 10 years of remaining life expectancy. The primary objective of this observational cohort study was to investigate the association between predicted 9‐year mortality and prostate cancer screening among American men aged ≥65 years in 2005 and 2010. The second objective was to analyze the proportions of men who discussed screening with their physicians.</p> </sec> <sec id="cncr28600-sec-0002" sec-type="section"> <title>METHODS</title> <p>Data were extracted from the 2005 and 2010 National Health Interview Surveys. Men aged ≥65 years without prostate cancer were divided into predicted 9‐year mortality quartiles. The proportions of men confirming a screening PSA within the prior year were determined. Logistic regression was used to compare screening rates.</p> </sec> <sec id="cncr28600-sec-0003" sec-type="section"> <title>RESULTS</title> <p>Screening rates for men aged ≥65 years were 48% in 2005 and 48% in 2010 (<italic>P</italic> = .9). Men ages 65 to 74 years who had <27% predicted 9‐year mortality were most commonly screened, with 56% screened in 2010, compared with 34% of men aged ≥75 years with >75% predicted 9‐year mortality. Approximately 55% of screened men aged ≥75 years who had ≥53% predicted 9‐year mortality recalled discussing the advantages of screening, whereas 25% recalled discussing the disadvantages.</p> </sec> <sec id="cncr28600-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Prostate cancer screening with PSA did not differ significantly between 2005 and 2010 for men aged ≥65 years based on predicted 9‐year mortality. Approximately 33% of older men with a high likelihood of 9‐year mortality were screened despite minimal clinical benefit. Twice as many men recalled discussing the potential advantages of screening compared with the disadvantages. <bold><italic>Cancer</italic> 2014;120:1491–1498.</bold> © <italic>2014 American Cancer Society</italic>.</p> </sec> </abstract>