The efficacy of prostate-specific antigen (PSA) screening for prostate cancer has received substantial attention in the medical literature and the media. However, the extent to which men are actually screened is unknown.
If practice were evidence-based, PSA screening would be less common among men than colorectal cancer screening. Colorectal screening is a preventive service of broad acceptance and proven efficacy.
In this study, researchers from the United States compared the prevalence of PSA and colorectal cancer screening among US men.
|Men are more likely to have been screened for prostate cancer than for colorectal cancer.|
|Journal of the American Medical Association|
The team used data from an annual population-based telephone survey of adults throughout the United States. They assessed a representative sample of 49,315 men aged 40 years or older.
The researchers looked at the proportions of men ever screened, and up to date on screening for prostate cancer (PSA testing) and colorectal cancer (fecal occult blood testing, flexible sigmoidoscopy, or colonoscopy).
They found that men are more likely to report having ever been screened for prostate cancer than for colorectal cancer.
The team determined that 75% of those aged 50 years or older have had a PSA test versus 63% for any colorectal cancer test.
Up-to-date PSA screening is also more common than colorectal cancer screening for men of all ages.
Additionally, in men aged 50 to 69 years, 54% reported an up-to-date PSA screen, while 45% reported up-to-date testing for colorectal cancer.
When the team analyzed the data state by state, they found men aged 50 to 69 years were more likely to be up to date on prostate cancer screening in 27 states. Up-to-date colorectal cancer screening was more common in only 1 state.
Dr Brenda Sirovich's team concluded, "Among men in the United States, prostate cancer screening is more common than colorectal cancer screening".
"Physicians should ensure that men who choose to be screened for cancer are aware of the known mortality benefit of colorectal cancer screening and the uncertain benefits of screening for prostate cancer."