Prostate Biopsies and Surgeries Seen to Fall in US After PSA Screening Found Wanting

Prostate Biopsies and Surgeries Seen to Fall in US After PSA Screening Found Wanting
The number of prostate biopsies and surgeries (radical prostatectomy, or RP) prescribed by doctors to diagnose and treat prostate cancer has dropped significantly since 2012, when a U.S. task force recommended against prostate-specific antigen (PSA) screening for this cancer, according to a study published in JAMA Surgery. The study, “National Trends in Prostate Biopsy and Radical Prostatectomy Volumes Following the United States Preventative Services Task Force Guidelines Against Prostate-Specific Antigen Screening,” is timely, its researchers said, as the task force recommendation is being reconsidered. In the 1990s, the United States implemented several screening programs for prostate cancer, based on the high incidence of this type of cancer and its high potential cure rate when detected in time. But some four years ago, the U.S. Preventative Services Task Force (USPSTF) discouraged PSA screening after a randomized clinical trial showed it of no benefit to mortality rates. PSA-based screening decreased significantly following this recommendation. Few studies since, however, have examined the recommendation's direct impact on diagnostic and therapeutic prostate cancer practices. Researchers analyzed the practice patterns of certifying and recertifying urologists, from 2009 through 2016, looking for changes in the number of prostate biopsies and RP procedures prescribed. The study included a representative sample of urologists across practice settings, and a nationally representative sample of all RP discharges from hospitals. Analysis indicated that, following the USPSTF recommendation, the m
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