Changes in prostate specific antigen (PSA) “screening” patterns by geographic region and socio-economic status in Australia: Analysis of medicare data in 50–69 year old men

Loading...
Thumbnail Image
File version
Accepted Manuscript (AM)
Author(s)
Kohar, Ankur
Cramb, Susanna M
Pickles, Kristen
Smith, David P
Baade, Peter D
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2023
Size
File type(s)
Location
License
https://creativecommons.org/licenses/by-nc-nd/4.0/
Abstract

Background: While it is known that national PSA testing rates have decreased in Australia since 2007, it is not known whether these trends are consistent by broad geographical areas, nor whether previously reported area-specific differences have remained in more recent time periods. Methods: Population-based cohort study of Australian men (n = 2793,882) aged 50–69 who received at least one PSA test (Medicare Benefit Schedule item number 66655) during 2002–2018. Outcome measures included age-standardised participation rate, annual percentage change using JoinPoint regression and indirectly standardised participation rate ratio using multivariable Poisson regression. Results: During 2005–09, two thirds (68%) of Australian men aged 50–69 had at least one PSA test, reducing to about half (48%) during 2014–18. In both periods, testing rates were highest among men living in major cities, men aged 50–59 years, and among men living in the most advantaged areas. Nationally, the Australian PSA testing rate increased by 9.2% per year between 2002 and 2007, but then decreased by 5.0% per year to 2018. This pattern was generally consistent across States and Territories, and socio-economic areas, however the magnitude of the trends was less pronounced in remote and very remote areas. Conclusions: The decreasing trends are consistent with a greater awareness of the current guidelines for clinical practice in Australia, which recommend a PSA test be done only with the informed consent of individual men who understand the potential benefits and risks. However, given there remain substantial geographical disparities in prostate cancer incidence and survival in Australia, along with the equivocal evidence for any benefit from PSA screening, there remains a need for more effective diagnostic strategies for prostate cancer to be implemented consistently regardless of where men live.

Journal Title
Cancer Epidemiology
Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
© 2023. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Rights Statement
Item Access Status
Note
Access the data
Related item(s)
Subject
Oncology and carcinogenesis
Epidemiology
Science & Technology
Life Sciences & Biomedicine
Oncology
Public, Environmental & Occupational Health
PSA screening
Persistent link to this record
Citation
Kohar, A; Cramb, SM; Pickles, K; Smith, DP; Baade, PD, Changes in prostate specific antigen (PSA) “screening” patterns by geographic region and socio-economic status in Australia: Analysis of medicare data in 50–69 year old men, Cancer Epidemiology, 2023, 83, pp. 102338
Collections