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Showing content from https://pubmed.ncbi.nlm.nih.gov/27060052/ below:

Decline in Prostate Cancer Screening by Primary Care Physicians: An Analysis of Trends in the Use of Digital Rectal Examination and Prostate Specific Antigen Testing

Multicenter Study

Affiliations

• ¹ Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York; Department of Biostatistics and Epidemiology (KVB), Weill Cornell Medical College, New York, New York. Electronic address: jes9171@nyp.org.
• ² Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York; Department of Biostatistics and Epidemiology (KVB), Weill Cornell Medical College, New York, New York.

• PMID: 27060052
• DOI: 10.1016/j.juro.2016.03.171

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Multicenter Study

Jonathan Shoag et al. J Urol. 2016 Oct.

• ¹ Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York; Department of Biostatistics and Epidemiology (KVB), Weill Cornell Medical College, New York, New York. Electronic address: jes9171@nyp.org.
• ² Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York; Department of Biostatistics and Epidemiology (KVB), Weill Cornell Medical College, New York, New York.

• PMID: 27060052
• DOI: 10.1016/j.juro.2016.03.171

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Purpose: Prostate cancer screening by digital rectal examination and prostate specific antigen testing has been routine clinical practice in the United States for the last 25 years. Recent studies have shown a national decline in prostate specific antigen testing following the USPSTF (United States Preventive Services Task Force) recommendation against routine prostate specific antigen screening. However, to our knowledge the effect of this recommendation on digital rectal examination utilization remains unknown.

Materials and methods: We used NAMCS (National Ambulatory Medical Care Survey) to characterize trends in the rate of digital rectal examination and prostate specific antigen testing by primary care physicians in men older than 40 years presenting for preventive care. From 2005 to 2012 NAMCS contained 3,368 such visits (unweighted) for the study of digital rectal examination trends and 4,035 unweighted visits from 2002 to 2012 for the study of prostate specific antigen trends.

Results: Following the USPSTF recommendation the proportion of visits where digital rectal examination was performed decreased from 16.0% (95% CI 13.1-19.5) to 5.8% (95% CI 4.0-8.3, p <0.001). Similarly, the proportion of visits where prostate specific antigen testing was performed decreased from 27.3% (95% CI 24.5-30.3) to 16.7% (95% CI 12.9-21.2, p <0.001). This represents a relative 64% decrease in digital rectal examination and a 39% decrease in prostate specific antigen testing. Among men 55 to 69 years old the number of visits where digital rectal examination and prostate specific antigen testing were performed decreased 65% and 39%, respectively (p <0.001).

Conclusions: Utilization of digital rectal examination and prostate specific antigen has declined significantly following the release of the USPSTF recommendation against prostate specific antigen screening. This suggests that prostate cancer screening is rapidly disappearing from primary care practice.

Keywords: digital rectal examination; mass screening; practice guideline; prostate specific antigen; prostatic neoplasms.

Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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• Reply by Authors.

  [No authors listed] [No authors listed] J Urol. 2016 Oct;196(4):1051-2. doi: 10.1016/j.juro.2016.03.193. Epub 2016 Jul 6. J Urol. 2016. PMID: 27393894 No abstract available.

• Editorial Comment.

  Carlsson S. Carlsson S. J Urol. 2016 Oct;196(4):1051. doi: 10.1016/j.juro.2016.03.192. Epub 2016 Jul 6. J Urol. 2016. PMID: 27393899 No abstract available.

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  Eapen RS, Herlemann A, Washington SL 3rd, Cooperberg MR. Eapen RS, et al. Curr Opin Urol. 2017 May;27(3):205-209. doi: 10.1097/MOU.0000000000000383. Curr Opin Urol. 2017. PMID: 28221220 Review.

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  Ryan ST, Sammon JD. Ryan ST, et al. Nat Rev Urol. 2016 Aug;13(8):444-5. doi: 10.1038/nrurol.2016.125. Epub 2016 Jul 12. Nat Rev Urol. 2016. PMID: 27400665 Review. No abstract available.

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  Bernstein AN, Shoag JE, Golan R, Halpern JA, Schaeffer EM, Hsu WC, Nguyen PL, Sedrakyan A, Chen RC, Eggener SE, Hu JC. Bernstein AN, et al. J Urol. 2018 Jun;199(6):1510-1517. doi: 10.1016/j.juro.2017.12.048. Epub 2017 Dec 26. J Urol. 2018. PMID: 29288121 Free PMC article.

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  Shah N, Ioffe V. Shah N, et al. Rev Urol. 2020;22(3):102-109. Rev Urol. 2020. PMID: 33239969 Free PMC article.

• An Automated Feature Engineering for Digital Rectal Examination Documentation using Natural Language Processing.

  Bozkurt S, Park JI, Kan KM, Ferrari M, Rubin DL, Brooks JD, Hernandez-Boussard T. Bozkurt S, et al. AMIA Annu Symp Proc. 2018 Dec 5;2018:288-294. eCollection 2018. AMIA Annu Symp Proc. 2018. PMID: 30815067 Free PMC article.

• Prostate cancer screening in Europe and Asia.

  Zhang K, Bangma CH, Roobol MJ. Zhang K, et al. Asian J Urol. 2017 Apr;4(2):86-95. doi: 10.1016/j.ajur.2016.08.010. Epub 2016 Sep 4. Asian J Urol. 2017. PMID: 29264211 Free PMC article. Review.

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