Prostate-specific antigen testing after the US Preventive Services Task Force recommendation: a population-based analysis of electronic health data



This study describes longitudinal trends in the use of prostate-specific antigen (PSA)-based testing in two geographically distinct healthcare systems following the 2011 US Preventive Services Task Force (USPSTF) recommendations against routine PSA screening.


We analyzed population-based health claims data from 253,139 men aged 40–80 who were enrolled at two US healthcare systems. We assessed trends in the percentage of eligible men receiving ≥ 1 PSA test per year by time period (2000–2008, 2009–2011, 2012–2014), age (40–54, 55–69, 70–80), and race (white, black, other, unknown), and conducted a joinpoint regression analysis.


Men aged 55–69 and 70–80 years of all races had similar use of PSA testing between 2000 and 2011, ranging between 47 and 56% of eligible men by year, while only 22–26% of men aged 40–54 had a PSA test per year during this period. Overall, the percentage of men receiving at least one PSA test per year decreased by 26% between 2009–2011 and 2012–2014, with similar trends across race and age groups. PSA testing declined significantly after 2011 (annual percent change = − 11.28).


Following the 2011 USPSTF recommendations against routine PSA screening, declines in PSA testing were observed among men of all races and across all age groups in two large US healthcare systems.

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This work was supported by a 2015 American Urological Association Data Grant to MHS. MME was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant KL2TR001454. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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DF and MME designed the study, interpreted the data, and wrote the first draft of the manuscript; HF and RK conducted all data analyses and commented on the manuscript; BAR and MHS helped conceive the idea for this study, interpreted the results, and commented on the manuscript. All authors read and approved the final manuscript.

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Correspondence to Mara M. Epstein.

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Frendl, D.M., Epstein, M.M., Fouayzi, H. et al. Prostate-specific antigen testing after the US Preventive Services Task Force recommendation: a population-based analysis of electronic health data. Cancer Causes Control 31, 861–867 (2020).

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  • Prostate-specific antigen
  • Screening
  • Prostate cancer
  • Healthcare claims