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UPJ INSIGHT Trends in Prostate Cancer Screening in the Pre– and Peri–COVID-19 Pandemic Period
By: Matthew James Davis, MD, MBA, Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan, Rutgers-New Jersey Medical School, Newark; Alex Stephens, MS, MA, Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan; Mohit Butaney, MD, Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan; Chase Morrison, BS, Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan; Nicholas Corsi, MD, Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan; Akshay Sood, MD, Ohio State University, Columbus; Albert Levin, PhD, Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan; Alexander P Cole, MD, Brigham and Women’s Hospital, Boston, Massachusetts; Quoc-Dienh Trinh, MD, MBA, Brigham and Women’s Hospital, Boston, Massachusetts; Craig Rogers, MD, Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan; Firas Abdollah, MD, Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan | Posted on: 15 Dec 2023
Davis M, Stephens A, Butaney M, et al. Trends in prostate cancer screening in the pre- and peri-COVID-19 pandemic period. Urol Pract. 2023;10(6):631-637.
Study Need and Importance
There is a need for the present study as the impact of the COVID-19 pandemic on prostate cancer screening remains to be fully elucidated. Prior studies on PSA testing during the COVID-19 pandemic did not adjust to variations in cohort characteristics, such as age, race, comorbidity, etc, which could affect PSA screening rates independently from the pandemic’s effect. Such an adjustment is important, given the previously established impact of these factors on PSA screening, such as with the change in the United States Preventive Services Task Force recommendations.
What We Found
The COVID pandemic was associated with missing first-time PSA testing opportunities, and subsequent cancer diagnoses will have been missed, especially for younger men (Figure). Although PSA testing rates rebounded at a higher rate in Black men in concordance with their classification as higher risk, there was also a higher rebound in PSA testing rates in men over 70 in discordance with most current guidelines.
Limitations
The limitations of the study include the cohort potentially failing to capture PSA testing performed outside of our health system, although this limitation is partially mitigated by the expanse of the health system as well as the various health system and public health efforts in the Detroit metropolitan area. Additionally, this study only included patients of our health system, so it is not necessarily representative of PSA testing trends across the entire United States. Finally, although our database contains many variables, it does not yet contain family history of prostate cancer as a variable.
Interpretation for Patient Care
The study results provide a better understanding of missed screening opportunities as well as discordances between guidelines and real-world practice patterns. Efforts ought to be made to initiate screening for young men in line with current guidelines.
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