Health Indicator Report of Prostate Cancer Screening

Notes

Age-adjusted to U.S. 2000 standard population. Old Methodology: Previous BRFSS methodology used "post-stratification" which was used to weight data by age, gender, and local health district (LHD). New Methodology: To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. With raking, education, race/ethnicity, marital status, home ownership/renter, and telephone source are included in the weighting procedure. Due to changes in sampling and weighting methodology, data from the new methodology represents a new baseline, and comparisons from new to old methodology data are not appropriate.

Data Interpretation Issues

To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. More details about these changes can be found at: [https://ibis.utah.gov/ibisph-view/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Definition

The percentage of men aged 40 and above who reported having a prostate-specific antigen (PSA) test in the last five years or who reported ever having had a PSA test.

Numerator

The number of men aged 40 and above who reported having had a PSA test within the specified time period.

Denominator

The total number of male survey respondents aged 40 or older excluding those who responded "don't know" or "refused" to the numerator question.

How Are We Doing?

In 2020, 36.7 percent of Utah men aged 40 and older reported ever receiving a prostate-specific antigen (PSA) test (age-adjusted rate). Since 2010, PSA testing has been declining which is expected since routine testing is no longer recommended (see Evidence-based Practices section). PSA testing rates in Utah increased significantly with age. For example, 11.1 percent of men aged 40 to 49 had ever had a PSA compared with 45.2 percent of men aged 50 to 64 and 70.6 percent of men aged 65 and older (2016-2020 data). From 2016-2020 Hispanic men were significantly less likely then non-Hispanic men to report ever having had a PSA test (29.1 percent compared with 41.4 percent, respectively).

How Do We Compare With the U.S.?

Historically, since 2002 rates of prostate-specific antigen (PSA) in the Utah male population have shown little difference in comparison to U.S. rates. However, since 2012 rates of PSA testing among Utah men aged 40 and older have been consistently lower than U.S. males of the same age.

Evidence-based Practices

Screening recommendations have changed over time. Until recently, many doctors and professional organizations encouraged yearly prostate-specific antigen (PSA) screening for men beginning at age 50. However, as more has been learned about both the benefits and harms of prostate cancer screening, a number of organizations have begun to caution against routine population screening. Although some organizations continue to recommend PSA screening, there is widespread agreement that any man who is considering getting tested should first be informed in detail about the potential harms and benefits. Currently, Medicare provides coverage for an annual PSA test for all Medicare-eligible men age 50 and older. Many private insurers cover PSA screening as well. Since 2018, the U.S. Preventive Services Task Force (USPSTF) recommends that those aged 55-69 with a prostate discuss the potential benefits and potential harms of prostate-specific antigen (PSA)-based screening for prostate cancer before deciding on whether or not to be screened. Healthy diet, exercise, and lifestyle play an important role in cancer prevention.