Decline in Use of Digital Rectal Examination, PSA Testing

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Following USPSTF recommendations, there has been a decrease in utilization of digital rectal examination and PSA testing,
Following USPSTF recommendations, there has been a decrease in utilization of digital rectal examination and PSA testing,

(HealthDay News) -- Following U.S. Preventive Services Task Force (USPSTF) recommendations against routine prostate-specific antigen (PSA) screening, there has been a decrease in utilization of digital rectal examination and PSA testing, according to a study published in The Journal of Urology.

Jonathan Shoag, M.D., from New York Presbyterian Hospital in New York City, and colleagues characterized trends in the rate of digital rectal examination and PSA testing by primary care physicians using the National Ambulatory Medical Care Survey for men older than 40 years presenting for preventive care. Data were included for 3,368 visits for the study of digital rectal examination trends from 2005 to 2012, and for 4,035 visits for the study of PSA trends from 2002 to 2012.

The researchers observed a decrease in the proportion of visits where digital rectal examination was performed following the USPSTF recommendation, from 16.0 to 5.8 percent (64 percent decrease; P < 0.001).

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A similar decrease from 27.3 to 16.7 percent was seen in the proportion of visits where PSA testing was performed (39 percent decrease; P < 0.001). For men aged 55 to 69 years, there were decreases of 65 and 39 percent, respectively, in the number of visits where digital rectal examination and PSA testing were performed (P < 0.001).

"This suggests that prostate cancer screening is rapidly disappearing from primary care practice," the authors write.

Reference

  1. Shoag K, Halpern JA, Lee DJ, et al. Decline in Prostate Cancer Screening by Primary Care Physicians: An Analysis of Trends in the Use of Digital Rectal Examination and Prostate Specific Antigen Testing. J Urol. 2016 Apr 5. doi: http://dx.doi.org/10.1016/j.juro.2016.03.171.

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