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 Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

nachricht Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union

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: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Pollen taxi for bacteria

18.07.2018 | Life Sciences

Biological signalling processes in intelligent materials

18.07.2018 | Life Sciences

Study suggests buried Internet infrastructure at risk as sea levels rise

18.07.2018 | Information Technology

VideoLinks
Science & Research
Overview of more VideoLinks >>>