Mary McNaughton Collins, MD, MPH Randall S. Stafford, MD, PhD Michael J. Barry, MD Boston, Massachusetts Submitted, revised, July 29, 1999. From the General Medicine Division, Medical Services, Massachusetts General Hospital. Presented in part at the National Society of General Internal Medicine meeting, Chicago, Ill, April 1998. Reprint requests should be addressed to Mary McNaughton Collins, MD, MPH, General Medicine Division, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114.
References
Conclusions
Our findings suggest that current prostate cancer screening decisions by primary care physicians are not sensitive to age. Some investigators argue that age alone should not guide decision making for screening because of the importance of health status. However, the overall age-specific mortality rate increases with age, decreasing the overall impact of a reduction in any disease-specific mortality rate.
Prostate cancer screening remains widespread, despite recommendations against routine screening by the United States Preventive Services Task Force and the ACP, and recommendations by the AAFP for counseling about the known risks and uncertain benefits of screening for prostate cancer. Also, the American Cancer Society and the American Urological Association have softened their previously strong recommendations for routine annual screening; they now suggest screening be offered annually. Whether these recommendations will have an impact on future primary care physician practice patterns for PSA testing is yet to be shown.
Acknowledgments
This work was supported in part by grants HS 08397 and HS 09538 from the Agency for Health Care Policy and Research.
