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Prosteria - National Trends and Outcomes of More Frequent than Guideline Recommended Prostate Specific Antigen Screening

Published:January 25, 2023DOI:https://doi.org/10.1016/j.urology.2023.01.011

      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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