KEY TAKEAWAYS
- The study aimed to assess the impact of annual PSA screening on PC mortality in elderly Medicare beneficiaries.
- Results showed that annual PSA screening may reduce PC deaths in men aged 67-74.
There is no consensus among clinical guidelines regarding the effectiveness of prostate-specific antigen (PSA) screening, particularly for elderly patients with prostate cancer (PC). Previous randomized trials have produced varied results, partly due to differences in adherence, and new trials are unlikely to be conducted.
Xabier García-Albéniz and the team aimed to estimate the impact of annual PSA screening on PC mortality among Medicare beneficiaries aged 67 to 84 years.
Researchers examined 2 approaches: annual PSA screening vs no screening, using data from 537,599 U.S. Medicare beneficiaries aged 67-84 between 2001 and 2008 with good life expectancy and no prior PC or PSA tests in the 2 years before the study.
They estimated the 8-year PC mortality, incidence, treatments, and treatment complications linked to PSA screening. This large-scale observational study aimed to understand the impact of annual PSA screening on patient outcomes.
The results indicated that in men aged 67-74, the 8 year risk of dying from PC was reduced by 2.3 deaths per 1,000 men with PSA screening compared to no screening (95% CI, -4.1 to -1.1), indicating a benefit of screening. However, PSA screening led to more treatment complications than no screening. In men aged 75-84, the difference in risk between screening and no screening was minimal, suggesting less benefit in this order group.
The study concluded that annual PSA screening over 8 years likely reduces PC mortality by 1 to 4 deaths per 1,000 men aged 67-74. However, results may be influenced by residual confounding in real-world data.
The study was funded by Steven and Christine Burd-Safeway Distinguished Professorship.
Source: https://pubmed.ncbi.nlm.nih.gov/39159422/
García-Albéniz X., Hsu J., Etzioni R., et al. (2024). “Prostate-Specific Antigen Screening and Prostate Cancer Mortality: An Emulation of Target Trials in US Medicare.” JCO clinical cancer informatics, 8, e2400094. https://doi.org/10.1200/CCI.24.00094
