ArticleJournal of the American Geriatrics Society2010
Variation in prostate-specific antigen screening in men aged 80 and older in fee-for-service Medicare.
Article in Journal of the American Geriatrics Society, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Association Between Receipt of Cancer Screening and All-Cause Mortality in Older Adults.JAMA network open · 2021Article
- Prostate-specific antigen testing among young men: an opportunity to improve value.Cancer medicine · 2021Article
- Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study.BMC public health · 2021Article
- A Retrospective Observational Analysis of Overall Survival with Sipuleucel-T in Medicare Beneficiaries Treated for Advanced Prostate Cancer.Advances in therapy · 2020Observational
- Characteristics of Physicians Participating in Medicare's Oncology Care Model Bundled Payment Program.Journal of oncology practice · 2019Article
- Exnovation of Low Value Care: A Decade of Prostate-Specific Antigen Screening Practices.Journal of the American Geriatrics Society · 2019Observational
- Knowledge, attitudes, and practices towards prostate cancer screening amongst men living in the southern Italian peninsula: the Prevention and Research in Oncology (PRO) non-profit Foundation experience.World journal of urology · 2017Article
- Real-world comparative risks of herpes virus infections in tofacitinib and biologic-treated patients with rheumatoid arthritis.Annals of the rheumatic diseases · 2016Article
- Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort study.BMC health services research · 2016Article
- Regional-Level Correlations in Inappropriate Imaging Rates for Prostate and Breast Cancers: Potential Implications for the Choosing Wisely Campaign.JAMA oncology · 2015Article
- Article
- Five-year downstream outcomes following prostate-specific antigen screening in older men.JAMA internal medicine · 2013Article
- Older adults and forgoing cancer screening: "I think it would be strange".JAMA internal medicine · 2013Article
- The impact of PSA screening on prostate cancer mortality and overdiagnosis of prostate cancer in the United States.The journals of gerontology. Series A, Biological sciences and medical sciences · 2013Article
- The influence of stress, depression, and anxiety on PSA screening rates in a nationally representative sample.Medical care · 2012Article
- Impact of the 2008 US Preventive Services Task Force recommendation to discontinue prostate cancer screening among male Medicare beneficiaries.Archives of internal medicine · 2012Article
- Remaining Life Expectancy Measurement and PSA Screening of Older Men.Journal of geriatric oncology · 2012Article
- Medical center characteristics associated with PSA screening in elderly veterans with limited life expectancy.Journal of general internal medicine · 2012Article
- Geritalk: communication skills training for geriatric and palliative medicine fellows.Journal of the American Geriatrics Society · 2012Article
- The role of community-based participatory research to inform local health policy: a case study.Journal of general internal medicine · 2011Article
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Funding
Abstract
objectivesTo determine the rate of prostate-specific antigen (PSA) screening in men aged 80 and older in Medicare and to examine geographic variation in screening rates across the U.S.
designRetrospective cohort study of variation across hospital referral regions using administrative data.
settingNational random sample in fee-for-service Medicare.
participantsMedicare beneficiaries aged 80 and older in 2003. MEASUREMENTS: Percentage of men aged 80 and older screened using the PSA test.
resultsThe national rate of PSA screening in men aged 80 and older was 17.2%, but there was wide variation across regions (<2-38%). Higher PSA screening in a region was positively associated with greater total costs (correlation coefficient (r)=0.49, P<.001), greater intensive care unit use at the end of life (r=0.46, P<.001), and greater number of unique physicians seen (r=0.36, P<.001). PSA screening was negatively associated with proportion of beneficiaries using a primary care physician as opposed to a medical subspecialist for the predominance of ambulatory care (r=-0.38, P<.001).
conclusionPSA screening in men aged 80 and older is common practice, although its frequency is highly variable across the United States. Its association with fragmented physician care and aggressive end-of-life care may reflect less reliance on primary care and consequent difficulty informing patients of the potential harms and low likelihood of benefit of this procedure.
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