The use of prostate specific antigen for prostate cancer screening: a managed care perspective

The Journal of Urology
M R Handley, M E Stuart

Abstract

A large nonprofit staff model Health Maintenance Organization experienced increased use of prostate specific antigen (PSA) as a screening test for prostate cancer beginning in May 1991. A critical evaluation of the evidence in support of PSA screening was done and concluded that the use of PSA to screen for prostate cancer did not meet the criteria for an effective screening program. A guideline stating that PSA was not recommended as a screening test was implemented focusing on a model of shared decision making. PSA test ordering decreased significantly when patients were fully informed about the evidence for PSA screening. If PSA screening had continued at the peak rate, the cascade of intervention initiated by screening would have resulted in significant complications and approximately $4,800,000 in increased costs.

References

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Citations

May 1, 1995·Journal of Surgical Oncology·G J Matthews, J A Fracchia
Oct 17, 2002·PharmacoEconomics·Christopher S Saigal, Mark S Litwin
Jul 31, 2004·International Journal of Palliative Nursing·Mary Ann MurrayMary Jane Jacobsen
Dec 1, 2001·Clinica Chimica Acta; International Journal of Clinical Chemistry·Peter S Bunting
Jul 30, 2005·Patient Education and Counseling·Gregory Makoul, Marla L Clayman

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