-- Robert Preidt
FRIDAY, Oct. 4 (HealthDay News) -- The large amount of money
that Medicare spends on PSA screening for prostate cancer provides
little benefit for older men, according to a new study.
Over three years, the Medicare fee-for-service program spent
more than $450 million a year on PSA (prostate-specific antigen)
screenings, one-third of which was for men over age 75, said the
researchers at Yale University's Cancer Outcomes, Public Policy and
Effectiveness Research Center.
But most prostate cancers are slow-growing and unlikely to
become a threat to older men, noted the researchers, who followed
prostate cancer-free, older male Medicare beneficiaries. The
investigators also noted that widespread PSA screening may lead to
unnecessary biopsies, which can be uncomfortable and even
In 2012, the U.S. Preventive Services Task Force stopped
recommending PSA screening for men of any age. However, Medicare
continues to reimburse for this test and follow-up procedures.
The benefits of PSA screening and treatment are not clear, the
study authors said. While men living in high-spending regions were
more likely to be diagnosed with localized cancers, they were not
significantly less likely to be diagnosed with metastatic
(spreading) cancer. This suggests that spending more on prostate
cancer screening might identify more localized tumors, but may not
necessarily reduce the rate of metastatic cancers.
The study, published in the Oct. 4 issue of the journal
Cancer, also found wide variation in the cost of prostate
cancer screenings in different regions of the country, ranging from
$16 to $65 per Medicare beneficiary. Most of the variation was not
due to the cost of the PSA test itself, but rather to differences
in the costs of follow-up tests.
"More than 70 percent of prostate cancer screening-related costs were due to follow-up procedures," study author Xiaomei Ma said in a Yale news release. "Our results suggest that the overall cost of prostate cancer screening may be heavily influenced by how urologists choose to respond to the result of a PSA test, more so than the use of the PSA itself."
The U.S. National Cancer Institute has more about the
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