US County-Level Study Shows Benefits of PSA Screening

TOPLINE:

US counties with higher rates of prostate-specific antigen (PSA) screening have lower rates of advanced/metastatic prostate cancer and prostate cancer mortality in later years, a county-level population-based study suggests.

METHODOLOGY:

  • Clinicians continue to debate the benefits and harms of PSA screening. To help clarify the value of PSA screening, researchers assessed the association between PSA screening rates by US county and incidence of metastatic prostate cancer and prostate cancer mortality by county.
  • The authors built a model using the 2004-2012 Behavioral Risk Factor Surveillance System (BRFSS), a national telephone survey tracking health-related data. The model was then post-stratified, or adjusted, using US census data to account for age, race, ethnicity, and county-level poverty rates.
  • The model estimated average PSA screening rates by county among men aged 40-79 years across all US counties between 2004 and 2012.
  • The study’s primary outcomes included age-adjusted incidence of late-stage prostate cancer by county between 2015 and 2019 as well as prostate cancer mortality between 2016 and 2020.

TAKEAWAY:

  • The analysis included data from 416,221 responses from the BRFSS, which was post-stratified using US census data from 63.4 million men aged 40-79 years from all 3143 US counties.
  • Overall, the researchers found that a 10% higher probability of PSA screening at the county level between 2004 and 2012 was associated with a 14% lower incidence of regional or distant prostate cancer between 2015 and 2019 (rate ratio [RR], 0.86; P < .001).
  • This 10% higher probability of PSA screening at the county level was also associated with a 10% lower risk for prostate cancer mortality between 2016 and 2020 (RR, 0.90; P < .001).

IN PRACTICE:

“This population-based ecological study found that United States counties with higher rates of PSA screening had lower rates of metastatic prostate cancer and prostate cancer mortality in subsequent years,” the researchers concluded.

SOURCE:

The study, led by Benjamin J. Stone, MD, of Brigham and Women’s Hospital, Boston, was published in The Journal of Urology and presented at the American Urological Association (AUA) 2024 Annual Meeting on May 4.

LIMITATIONS:

The abstract did not include any study limitations.

DISCLOSURES:

No funding or relevant financial relationships were declared.

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