Prostate Cancer Screening Rates in Privately Insured US Patients

Chicago—The US Preventive Services Task force recommends against prostate-specific antigen (PSA)-based screening for prostate cancer, giving the screening a grade D in a 2012 review. In addition, little is known about the degree to which prostate cancer screening has changed with recent clinical research data.

A study was discussed during a poster presentation at the ASCO 2015 Annual Meeting by Simon P. Kim and colleagues, which examined the national trends of PSA screening to understand which patient characteristics were associated with PSA testing [J Clin Oncol. 2015;33; abstract 5065]. The poster was titled Contemporary national trends of prostate cancer screening among privately insured patients in the United States.

The researchers utilized a large private health insurance database—Optum Labs Data Warehouse—to identify males aged 40 to 80 years who had undergone prostate cancer screening between 2008 and 2013.

The study’s primary end point was use of PSA testing among a privately insured population-based cohort. Demographic covariates analyzed by the researchers included age, census region, race, education level, and household income. The Charlson/Deyo comorbidity index was used to calculate comorbidity burden, which was based on member-years and reported per 1000 member-years.

The researchers identified 11.6 million eligible enrollees and narrowed down to 2.9 million men (25%) who underwent PSA screening during the study’s time period. More than 800,000 men were screened per year. The majority of the screened population were white males aged 50 to 59 years residing in the Southern census region.

The rate of men undergoing PSA screening remained stable from 190.4 per 1000 member-years in 2008 to 196.4 in 2013 (P=.66). PSA screenings remained stable among men aged 50 to 74 years, though patients older than 75 years of age showed a decrease in PSA screening from 201.5 per 100 member-years in 2008 to 124.1 per 1000 member-years in 2013 (P=.04).

The researchers did not find any screening discrepancies related to race or geographic region over time.

The researchers concluded, “In this large population-based cohort of privately insured men, we found little effect of new data and change in clinical practice guidelines on the overall rate of PSA screening. However, older men (>75 [years of age]) showed a significant reduction in screening over time.”

Source: Kim SP, Karnes J, Gross CP, et al. Contemporary national trends of prostate cancer screening among privately insured patients in the United States. Abstract of poster presentation at the American Society of Clinical Oncology 2015 Annual Meeting, Chicago, Illinois, May 30, 2015.