Changes in Prostate Cancer Presentation Following the 2012 USPSTF Screening Statement: Observational Study in a Multispecialty Group Practice

Excerpt

In this issue of the Journal of General Internal Medicine, Presti and colleagues present an analysis of the incidence of PSA testing, prostate biopsy, any prostate cancer, and first presentations with metastatic disease among men in the Kaiser Permanente of Northern California Health Plan.¹ The analysis was planned to examine the effect of the 2012 US Preventive Task Force “D” recommendation against PSA screening on these rates.² No data on prostate cancer mortality are presented. Reasonably, their primary comparisons were the population-based incidence for these parameters between 2010–2011 (pre-guideline) and 2014–2015 (post-guideline). The years 2012–2013 were considered “transition years.” In this large population of men, between the two key time intervals, the paper reports PSA screening rates dropped about 23%, biopsy rates dropped 64%, incident prostate cancer rates dropped 54%, and initial presentations with metastatic cancer increased 37%. Because of the sample size, confidence intervals around these point estimates are tight. …