Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

More than 40 percent of men over 75 undergo PSA screening despite national recommendations

16.10.2013
Study looks at role of primary care physicians

Many primary care doctors continue to administer the prostate-specific antigen test to even their oldest patients despite the fact that no medical organization recommends prostate cancer screening for men older than 75, according to new research from the University of Texas Medical Branch at Galveston.

In a research letter published in the Journal of the American Medical Association, UTMB researchers found a high variability in standard PSA-ordering practice among primary care physicians. Some doctors ordered the test for their older male patients regularly, despite more than a decade of recommendations against doing so. The doctors' tendency to order the test had little to do with measurable patient characteristics.

"Our results suggest that a major reason for the continued high PSA rate is decision-making by the physicians," said senior author Dr. James Goodwin, director of UTMB's Sealy Center on Aging. "That's why there was so much variation among physicians, after accounting for differences among patients. It is clear that some of the overuse is because of preferences of individual patients, but the conclusion of our results is that much more is coming from their primary care physicians."

The purpose of UTMB study was to determine the role primary care physicians play in whether a man receives PSA screening. The study looked at the complete Medicare Part A and Part B data for 1,963 Texas physicians who had at least 20 men age 75 or older in their panels and who saw a man three or more times in 2009. Of the 61,351 patient records examined, 41 percent of men received a PSA screening that year, and 29 percent received a screening ordered by their primary care physician.

Which primary care physician a man sees explained approximately seven times more of the variance in PSA screening than did the measurable patient characteristics, such as age, ethnicity, and location, according to the study.

"Overtesting can create harms, including overdiagnosis," said Dr. Elizabeth Jaramillo, lead author and an instructor of internal medicine-geriatrics at UTMB. "The vast majority of prostate cancers are so slow growing that an elderly man is much more likely to die of another condition in his lifetime than from the cancer."

Additional research is needed to understand why some primary care physicians order PSA screenings more often than others. The study suggests that overtesting rates be included as quality measures of PCPs. Medicare data can be used to generate such measures.

Co-authors include biostatistician Alai Tan, research associate Liu Yang and professor Yong-Fang Kuo. The research was supported by the Cancer Prevention Research Institute of Texas, the National Institutes of Health, the Agency for Healthcare Research and Quality and the UTMB Clinical and Translational Science Award.

Of Note:

Routine prostate cancer screening for asymptomatic patients — especially older ones — has been criticized by many organizations over the past dozen years. The American Cancer Society, the American Academy of Family Physicians and the American College of Physicians have all called for curtailing routine annual PSA testing because it so often leads to unnecessarily aggressive treatment that can cause impotence and incontinence.

The screening test detects the presence of PSA, a protein produced by the prostate gland. Traditional thinking was that the higher a man's PSA level, the more likely he was to have prostate cancer. New evidence shows that many factors can increase a man's PSA level, and that even if cancer is one of those factors, most prostate cancer is so slow growing it will never progress to a dangerous level.

According to a 2012 study by the National Cancer Institute, a 13-year cancer screening trial showed that men who undergo annual PSA screening have roughly the same death rate from prostate cancer as men who don't.

The U.S. Preventive Services Task Force called for the elimination of routine PSA screening in 2012. In May the American Urological Association said routine PSA screening should be limited to men between 55 and 69.

The University of Texas Medical Branch
Office of Marketing and Communications
301 University Boulevard
Galveston, Texas 77555-0144
http://www.utmb.edu
ABOUT UTMB HEALTH: Texas' first academic health center opened its doors in 1891 and today comprises four health sciences schools, three institutes for advanced study, a research enterprise that includes one of only two national laboratories dedicated to the safe study of infectious threats to human health, and a health system offering a full range of primary and specialized medical services throughout Galveston County and the Texas Gulf Coast region. UTMB Health is a component of the University of Texas System and a member of the Texas Medical Center.

Molly Dannenmaier | EurekAlert!
Further information:
http://www.utmb.edu

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

Bare bones: Making bones transparent

27.04.2017 | Life Sciences

Study offers new theoretical approach to describing non-equilibrium phase transitions

27.04.2017 | Physics and Astronomy

From volcano's slope, NASA instrument looks sky high and to the future

27.04.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>