February 23, 2016
Primary Care Physicians and Urologists Respond Differently to Recommendations Against PSA Screening.Thomas L. Schwenk, MD reviewing Zavaski ME et al. JAMA Intern Med 2016 Feb 8.Use of prostate-specific antigen testing declined dramatically among primary care physicians.
Controversy is ongoing about use of prostate-specific antigen (PSA) testing to screen for prostate cancer. In late 2011,
the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against PSA screening for all men (NEJM JW Gen Med Jul 1 2012 and Ann Intern Med 2012; 157:120). To assess the effect of this recommendation on PSA testing frequency, researchers used a national ambulatory care survey to identify 2300 men (age range, 50–74) who visited primary care physicians or urologists for preventive services in 2010 and 2012 (i.e., before and after the recommendation was issued). Men with any prostate or previous PSA abnormalities were excluded.
Between 2010 and 2012, use of PSA testing fell significantly, from 37% to 16%, among men who visited primary care providers. Testing rates decreased from 39% to 35% among men who saw urologists.
COMMENT
Primary care physicians and urologists appear to have responded differently to the USPSTF recommendation against PSA screening, possibly because of differences in their patient populations, their experience with prostate cancer, their interpretation of the data that led to the recommendation, and conflict between the USPSTF guideline and the American Urological Association guideline that was in effect in 2010 and 2012 and favored screening. ( στην Ελλάδα τουλάχιστον είναι και το θέμα το βιοποριστικό, λόγω της υπερπληθώρας των ειδικών Ουρολόγων).EDITOR DISCLOSURES AT TIME OF PUBLICATION
Disclosures for Thomas L. Schwenk, MD at time of publication
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CITATION(S):
Zavaski ME et al. Differences in prostate-specific antigen testing among urologists and primary care physicians following the 2012 USPSTF recommendations. JAMA Intern Med 2016 Feb 8; [e-pub]. (Δεν είναι ορατοί οι σύνδεσμοι (links).
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Ενδιαφέρον παρουσιάζουν και τα δύο (μέχρι τώρα τουλάχιστον) Reader Comments:John Coop er Physician, Family Medicine/General Practice, Outpatient
25 Feb 2016 8:53 PM
In my 40 years of clinical practice I have had less than 10 men die of metastatic prostate cancer. Probably around 20 men with serious complications of prostate biopsy--bleeding, sepsis. Dozens with disabling GU symptoms. Very difficult call.
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Είσοδοςκαι το δεύτερο:Maarte n VASBIN DER Physician, Family Medicine/General Practice
24 Feb 2016 1:16 PM
In the Trump year, it has been made possible to be not politically correct. The difference in PSA recommendations is based on money and nothing else. Please dare to say it.
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Θέμα: Prostate-cancer: To screen or not? (Αναγνώστηκε 86001 φορές)
13 Οκτωβρίου 2011, 09:33:53