National Trends in PSA Cancer Screening With Parallel Investigation of Colorectal Cancer Screening: An Analysis of the CDC Behavioral Risk Factor Surveillance System From 2012 to 2022

Introduction/ BackgroundFrom 2012 to 2022 there have been numerous revisions in the United States Preventative Task Force guidelines for prostate cancer screening, including out-right advising against PSA testing to allowing testing with shared-decision making for men between the ages of 55-69. We sought to observe trends in PSA testing rates in this timeframe in relation to the changing guidelines. Conversely, in the same time frame, colorectal cancer screening recommendations remained consistent for patients aged 50-75 and we sought to use this as a comparison to observe the effect of differing guidelines.MethodsThe Centers for Disease Control Behavioral Risk Factor Surveillance System is a national database of surveys on health-related behaviors and preventive medical services. We extracted data from 2012-2022 where respondents were asked about both prostate cancer screening and colorectal cancer screening. Our primary variable of interest was prostate cancer screening and colorectal cancer screening was used as a positive control.ResultsProstate cancer screening decreased among respondents from 70.1% in 2012 to 59.7% in 2022. However, there was a significant rebound in prostate cancer screening prevalence in 2022 from the previous year of 2020. In contrast, colorectal cancer screening rates steadily increased from 70.7% in 2012 to 78% in 2022. From 2012 to 2022, the annual percentage of men who had received prostate cancer screening was statistically different year to year.ConclusionsTrends in the rate of screening for prostate cancer and colorectal cancer appeared to adapt to the updated recommendations of USPTF. However, further investigation regarding lower income levels, minority groups, and uninsured men are essential to address the social and racial disparities seen in prostate cancer screening. Efforts to promote shared-decision making may improve effective cancer screening.MicroAbstractThe objective was to evaluate how changes in the guideline recommendations correlated with prostate cancer screening rates from 2012 to 2022 and if there were any associated demographic trends. Our population includes men interviewed through the Centers for Disease Control Behavioral Risk Factor Surveillance System, and overall, it has demonstrated that prostate cancer screening trends reflect the United States Preventative Task Force guideline recommendations. Notably, the study emphasized the need to promote and improve shared-decision making, particularly in men within vulnerable populations.