A continuous fall of PSA use for prostate cancer screening among Brazilian doctors since 2001. Good or bad notice?
Int. braz. j. urol
; 45(3): 478-485, May-June 2019. tab, graf
Article
in En
| LILACS
| ID: biblio-1012323
Responsible library:
BR1.1
ABSTRACT
ABSTRACT Purpose:
To evaluate the trend of use of Prostate Specific Antigen (PSA) for screening of prostate cancer (PC) among Brazilian doctors, from the beginning of its regular availability in clinical laboratories. Material andMethods:
A serial cross-sectional study was performed using data obtained from a large database between 1997 and 2016. The general PSA screening trend during this period, adjusted for the total number of exams performed in men, was analyzed. Time-series analysis was performed through observation of the general regression curve using the generalized least squares method, and the impact of the recommendations was assessed with autoregressive integrated moving average (ARIMA) models.Results:
During the period studied 2,521,383 PSA determinations were done. The age of the participants ranged from 21 to 111 years, with an average of 56.7 ± 22.7 years. The relative number of PSA tests/100.000 exams in males showed a constant reduction since 2001, and this trend was more evident in the group aged 55-69 years. Although statistically significant, the impact of reduced PSA screening after the 2012 USPSTF publication was clinically irrelevant.Conclusions:
Our results indicated a continuous reduction in the use of PSA screening over time, regardless of the publication of recommendations or clinical guidelines. The fact that this trend was more pronounced among those with a greater benefit potential (55-69 years), relative to groups with a greater damage potential due to overdiagnosis and overtreatment (aged >74 years and <40 years), is a matter of concern. Follow-up studies of these trends are advisable.Key words
Full text:
1
Collection:
01-internacional
Database:
LILACS
Main subject:
Prostatic Neoplasms
/
Prostate-Specific Antigen
/
Early Detection of Cancer
Type of study:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
/
Aged
/
Aged80
/
Humans
/
Male
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Int. braz. j. urol
Journal subject:
UROLOGIA
Year:
2019
Document type:
Article
Affiliation country:
Brazil
Country of publication:
Brazil