Small decrease in PSA testing at some VA medical centers

A new report in the Journal of the National Cancer Institute states that since the publication of the PLCO and ERSCP data on prostate cancer screening in early 2009, there has been a small reduction in the number of men requesting PSA testing at eight group practices in the Veterans Health Administration Pacific Northwest Network.

According to the new article by Zeliadt et al., the relative reduction in PSA testing was between 5.5 and 9.1 percent between August 2009 and March 2010, which equates to an absolute reduction of between 2.2 and 3.0 percent, depending on the age group of the men being tested. The details of the report by Zeliadt and his colleagues (not yet available on line) and an accompanying editorial comment by Yao and Lu-Yao have been well covered in an article on the Medscape Oncology web site.

It has to be noted that it is utterly unclear whether these results from a selected subset of men eligible for testing at VA medical centers is applicable to the rest of the U.S. population. Zeliadt and his colleagues and Yao and Lu-Yao have different opinions as to whether — on average — the men in this VA subpopulation get more or less PSA testing than men in the US population > 40 years of age as a whole.

What’s the bottom line here? Probably only that, because there was no really clear evidence from the PLCO and the ERSCP trials about the value of PSA screening one way or another, there was also little real effect on the use of PSA testing in clinical practice within the first year after publication of the trial results.

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