Prostate-Specific Antigen Screening According to Health Professional Counseling and Age in the United States.

Abstract

Background: In 2018, the US Preventive Services Task Force recommended that PSA screening for prostate cancer involve men aged 55-69, based on a personal decision following consultation with a health professional. PSA screening in men aged 70 or older should only occur if symptoms exist. This study identifies the association between having a PSA test in the past two years and whether or not there was consultation with a health professional about the benefits and/or harms of PSA screening.

Methods: Analyses were based on data involving men aged 40 years or older, who responded to PSA related questions in the 2018 BRFSS survey.

Results: Approximately 32.0% (14.6% for ages 40-54, 41.7% for ages 55-69, and 49.8% for ages 70 years and older) of respondents had a PSA test in the past two years. Approximately 81.7% of these men had talked with a health professional about the benefits and/or harms of PSA screening, with 42.4% having discussed the benefits and harms, 54.6% having discussed the benefits only, and 3.0% having discussed the harms only. The odds of a PSA test in the past two years in men having talked with a health professional about the benefits and harms of the test versus no talk are 10.1 (95% CI 9.3-10.8), in men who talked with a health professional about the benefits only versus no talk are 10.8 (95% CI 10.0-11.6), and in men who talked with a health professional about the harms only versus no talk are 3.9 (95% CI 2.9-5.1).

Conclusion: PSA screening is most common in men aged 70 or older, which is counter to the US Preventive Task Force recommendation. Most men having a PSA test have talked with a health professional about the test, but the talks tended to focus on just the benefits of screening and not both potential benefits and harms.