Pd19-02 the Association of County-Level Prostate-Specific Antigen Screening With Metastatic Prostate Cancer and Prostate Cancer Mortality

You have accessJournal of UrologyProstate Cancer: Detection & Screening II (PD19)1 May 2024PD19-02 THE ASSOCIATION OF COUNTY-LEVEL PROSTATE-SPECIFIC ANTIGEN SCREENING WITH METASTATIC PROSTATE CANCER AND PROSTATE CANCER MORTALITY Benjamin J. Stone, Muhieddine Labban, Edoardo Beatrici, Dejan K. Filipas, Anthony V. D'Amico, Stuart R. Lipsitz, Toni K. Choueiri, Adam S. Kibel, Alexander P. Cole, Hari S. Iyer, and Quoc-Dien Trinh Benjamin J. StoneBenjamin J. Stone , Muhieddine LabbanMuhieddine Labban , Edoardo BeatriciEdoardo Beatrici , Dejan K. FilipasDejan K. Filipas , Anthony V. D'AmicoAnthony V. D'Amico , Stuart R. LipsitzStuart R. Lipsitz , Toni K. ChoueiriToni K. Choueiri , Adam S. KibelAdam S. Kibel , Alexander P. ColeAlexander P. Cole , Hari S. IyerHari S. Iyer , and Quoc-Dien TrinhQuoc-Dien Trinh View All Author Informationhttps://doi.org/10.1097/01.JU.0001009448.41537.64.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There exists ongoing debate about the benefits and harms of PSA screening. We sought to evaluate the association of county-level PSA screening rates with county-level incidence of metastatic prostate cancer and prostate cancer mortality in the United States. METHODS: This study used data from the 2004-2012 Behavioral Risk Factor Surveillance System (BRFSS) to build a multilevel mixed effects model with poststratification using US Census data to estimate county-level PSA screening rates for all 3,143 United States counties adjusted for age, race, ethnicity, and county-level poverty rates. The exposure of interest was average county-level estimated PSA screening rate from 2004-2012, defined as the proportion of men aged 40-79 who underwent PSA screening within the prior 2 years. The primary outcomes were age-adjusted incidence of regional/distant prostate cancer 2015-2019 and age-adjusted prostate cancer mortality 2016-2020. RESULTS: 416,221 male BRFSS respondents aged 40-79 met inclusion criteria and were used in the multilevel mixed effects model. The model was post-stratified using 63.4 million men aged 40-79 from all 3,143 counties in the 2010 Decennial Census. County-level estimated PSA screening rates exhibited geographic variability (Figure 1) and were pooled at the state level for internal validation with direct BRFSS state-level estimates, showing strong correlation with Pearson correlation coefficients 0.77-0.90. A 10% higher county-level probability of PSA screening 2004-2012 was associated with 14% lower county-level incidence of regional/distant prostate cancer 2015-2019 (rate ratio 0.86, 95% CI 0.85-0.87, p<0.001, Figure 2) and 10% lower county-level prostate cancer mortality 2016-2020 (rate ratio 0.90, 95% CI 0.89-0.91, p<0.001). CONCLUSIONS: This population-based ecological study found that United States counties with higher rates of PSA screening had lower rates of metastatic prostate cancer and prostate cancer mortality in subsequent years. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e439 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Benjamin J. Stone More articles by this author Muhieddine Labban More articles by this author Edoardo Beatrici More articles by this author Dejan K. Filipas More articles by this author Anthony V. D'Amico More articles by this author Stuart R. Lipsitz More articles by this author Toni K. Choueiri More articles by this author Adam S. Kibel More articles by this author Alexander P. Cole More articles by this author Hari S. Iyer More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement PDF downloadLoading ...