Abstract
Objective
To characterize national trends in and associated outcomes of more often than annual
PSA screening, which we term “prosteria”.
Methods
Men in the Optum Clinformatics® Data Mart with ≥ 2 years from first PSA test to censoring
at the end of insurance or available data (January 2003 to June 2019) or following
exclusionary diagnoses or procedures, such as PCa treatment, were included. PSAs within
90 days were treated as one PSA. Prosteria was defined as having ≥3 PSA testing intervals
of ≤270 days.
Results
9,734,077 PSAs on 2,958,923 men were included. The average inter-PSA testing interval
was 1.5 years, and 4.5% of men had prosteria, which increased by 0.53% per year. Educated,
wealthy, non-White patients were more likely to have prosteria. Men within the recommended
screening age (i.e. 55-69) had lower rates of prosteria. Prosteria patients had higher
average PSA values (2.5 vs 1.4 ng/ml), but lower values at PCa diagnosis. Prosteria
was associated with biopsy and PCa diagnosis; however, there were comparable rates
of treatment within 2 years of diagnosis.
Conclusion
In this large cohort study, prosteria was common, increased over time, and was associated
with demographic characteristics. Importantly, there were no clinically meaningful
differences in PSA values at diagnosis or rates of early treatment, suggesting prosteria
leads to both overdiagnosis and overtreatment. These results support current AUA and
USPTF guidelines and can be used to counsel men seeking more frequent PSA screening.
Key Words
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Article info
Publication history
Accepted:
January 9,
2023
Received:
September 15,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Prior Presentations: An abstract related to this work was presented at the 2021 American Urological Society Annual Meeting (Las Vegas, NV, U.S.). This abstract was published: Peterson, D, et al. "PD50-01 Prosteria: A Claims-Based Study of Demographic and Temporal Trends in Frequent Prostate Specific Antigen Testing." The Journal of Urology 206. Supplement 3 (2021): e851.
Disclaimers: None
Identification
Copyright
© 2023 Published by Elsevier Inc.
