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Research Letter
November 2014

Contemporary Nationwide Patterns of Self-reported Prostate-Specific Antigen Screening

Author Affiliations
  • 1Vattikuti Urology Institute Center for Outcomes Research, Analytics, and Evaluation, Henry Ford Health System, Detroit, Michigan
  • 2Division of Urologic Surgery, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 3Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
  • 4Center for Surgery and Public Health, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2014;174(11):1839-1841. doi:10.1001/jamainternmed.2014.4117

Routine screening for prostate cancer using prostate-specific antigen (PSA) is a widely contested practice, and recommendations have recently changed dramatically. In October 2011, the US Preventative Services Task Force recommended against screening in any age group,1 yet current nationwide patterns of PSA screening are largely unknown. We sought to elucidate contemporary PSA screening prevalence with a focus on heterogeneity among states and across age groups. We examine data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS).

The BRFSS is the world’s largest continuously conducted health survey, a joint initiative of the Centers for Disease Control and Prevention and US states. Male respondents 50 years or older without a history of prostate cancer or prostate problem who reported PSA testing within the 12 months preceding the 2012 BRFSS survey were considered to have undergone screening. The 2012 survey was conducted between January 2, 2012, and February 12, 2013. Complex-samples logistic regression analysis incorporating age, race and/or ethnicity, education, income, residence location, insurance status, access to regular health care, and marital status was used to estimate an individual’s predicted probability of undergoing PSA screening. Individual probabilities were then normalized to the 2012 BRFSS screened population to derive state-specific estimates of screening prevalence.