Examining Changes in Prostate Cancer Survival Related to USPSTF Screening Recommendations

A new study shows that the U.S. Preventative Services Task Force’s (USPSTF) 2012 recommendation against prostate-specific antigen (PSA)-based screening for prostate cancer have hindered insured patients and resulted in worse outcomes. The findings were reported in BMC Urology.

The researchers assessed prostate cancer-specific survival (PCSS) based on time of diagnosis and insurance type using the SEER 18 database. Patients were placed in the pre-USPSTF era if they were diagnosed in 2010-2012, or the post-USPSTF era if diagnosed in 2014-2016. The investigators used Kaplan-Meier analysis to measure PCSS, and Cox proportional modeling to assess disparities.

According to the findings, uninsured patients experienced worse PCSS compared to insured patients pre-USPSTF (adjusted HR=1.256, 95% CI, 1.037-1.520, p = 0.020). The researchers noted that this survival disparity was not observed post-USPSTF owning to decreased PCSS among insured patients combined with unchanged PCSS among uninsured patients (adjusted HR=0.946, 95% CI, 0.642-1.394, p = 0.780).

“Although the underlying reasons are not clear, the USPSTF’s 2012 PSA screening recommendation may have hindered insured patients from being regularly screened for prostate cancer and selectively led to worse outcomes for insured patients without affecting the survival of uninsured patients,” the researchers concluded.