Prostate specific antigen utilization trends in an academic hospital in Argentina.
DOI:
https://doi.org/10.31053/1853.0605.v76.n4.25185Keywords:
prostatic neoplasms, mass screening, prostate-specific antigen, medical overuseAbstract
Background. Although prostate cancer (PC) screening with prostate-specific antigen (PSA) determination could decrease mortality, concerns about the potential risk of overdiagnosis led to recommendations against this preventive practice. The objective of this study was to describe the trend in PSA determinations in men between 40 and 79 years old, affiliated to a Health Maintenance Organization (HMO) of an academic hospital in the city of Buenos Aires, Argentina, and its association with the recommendations stated by the U.S. Preventive Task Force (USPSTF) and the Instituto Nacional del Cáncer in Argentina.
Methods. We analyzed a time series of aggregated data. We calculated the annual age-standardized rates of accumulated determinations of PSA for every 100 affiliates without a personal history of PC. Additionally, we compared trends by age groups every 10 years. We used Joinpoint and MS Excel programs.
Results. Between 2006 and 2011 there was a growing trend in the number of PSA determinations, with an annual average of + 1.2% (95% CI, -1.0 to +3.5). Between 2011 and 2015, the number of determinations began to decrease, with a percentage annual average of -4.1% (-6.9 to -1.1).
Conclusion. We found a gradual decrease in PSA utilization in men between 40 and 79 years old after the 2012 USPSTF recommendation against prostate cancer screening.
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