Impact of the 2012 and 2018 USPSTF statements on prostate cancer screening and metastatic rates in Kaiser Permanente Northern California.

Abstract

359 Background: To assess how the United States Preventive Services Task Force (USPSTF) Prostate Cancer Screening Statements of 2012 (Grade D - “recommends against”) and 2018 (Grade C - “selectively offering...based on professional judgment and patient preferences”) influenced race-specific rates of PSA screening and metastatic cancer at presentation among screen-eligible men in Kaiser Permanente Northern California. Methods: This is a retrospective study from 2006 to 2022, in screen-eligible (ages 50-69), Kaiser Permanente Northern California members. We compared the race-specific rates of PSA screening and metastatic cancer at presentation before and after the changes in the USPSTF Statements. Results: In 2006 there were 324,950 screen-eligible men (11% Black, 17% Asian, 73% White). In 2022 there were 434,705 screen-eligible men (11% Black, 27% Asian, 63% White). Race-specific, annual screening and metastatic rates are shown (Table). Following the 2012 USPSTF statement, all races experienced similar declines in screening and an increase in metastatic rates which was greatest among Black men. Following the 2018 statement, all races experienced similar increases in screening (with the exception of the time around the pandemic in 2020); yet as of 2022, the rate of metastatic cancer has continued to increase. Conclusions: The 2012 USPSTF Statement (Grade D) was associated with a decline in screening and an increase in metastatic rates among all races, yet was greatest among Black men, a high-risk group. Following the 2018 USPSTF Statement (Grade C), screening rates have increased yet metastatic rates continue to rise and remains greatest among Black men. Biennial race-specific screening and metastatic rates. 2006 2008 2010 2012 2014 2016 2018 2020 2022 Screening Rates(per 100,000 person-yrs) Asian 477 511 512 453 406 370 380 262 432 Black 441 452 468 398 364 328 338 255 381 White 438 461 455 398 354 315 329 242 384 Metastatic Rates(per 100,000 person-yrs) Asian 0.06 0.22 0.08 0.06 0.12 0.20 0.25 0.16 0.34 Black 0.44 0.34 0.33 0.31 0.66 0.76 0.85 0.72 1.18 White 0.26 0.23 0.19 0.17 0.30 0.31 0.42 0.48 0.73