The following is a summary of “Prosteria – National Trends and Outcomes of More Frequent Than Guideline Recommended Prostate Specific Antigen Screening,” published in the APRIL 2023 issue of Urology by Peterson, et al.
For a study, researchers sought to characterize national trends in more frequent than annual prostate-specific antigen (PSA) screening, termed “prosteria,” and evaluate its associated outcomes.
The study included men from the Optum Clinformatics Data Mart with at least two years between their first and last PSA test, censoring at the end of insurance coverage or available data (January 2003 to June 2019). Men with exclusionary diagnoses or procedures, such as prostate cancer (PCa) treatment, were excluded. Multiple PSAs within 90 days were considered as one PSA. Prosteria was defined as having three or more PSA testing intervals of ≤270 days.
A total of 9,734,077 PSA tests from 2,958,923 men were included in the analysis. The average interval between PSA tests was 1.5 years, and 4.5% of men had prosteria, with an increasing prevalence of 0.53% per year. Prosteria was more common in educated, wealthy, and non-White patients. Men within the recommended screening age range (55-69 years) had lower rates of prosteria. Prosteria patients had higher average PSA values (2.5 ng/mL vs. 1.4 ng/mL) but lower PSA values at PCa diagnosis. Prosteria was associated with an increased likelihood of undergoing a biopsy and receiving a PCa diagnosis, but treatment rates within two years of diagnosis were comparable to other groups.
Prosteria, characterized by more frequent than annual PSA screening, was prevalent and increasing over time. It was associated with specific demographic characteristics. Importantly, prosteria did not result in clinically meaningful differences in PSA values at diagnosis or rates of early treatment, indicating a potential for both overdiagnosis and overtreatment.
The findings supported the current guidelines of the American Urological Association (AUA) and the U.S. Preventive Services Task Force (USPSTF) and can serve as counseling information for men seeking more frequent PSA screening.
Source: goldjournal.net/article/S0090-4295(23)00055-9/fulltext