Preventative Care and 1 more...less...

G3O1. Increase screenings for preventative diseases that is in our top 10 causes of deaths

Increase the percentage of men 40+ who received a prostate cancer screening

28.9%2020

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Story Behind the Curve

In 2018 USPSTF changed their recommendations for prostate cancer screening. For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)-based screening for prostate cancer should be an individual one. Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of screening with their clinician and to incorporate their values and preferences in the decision. Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs. Clinicians should not screen men who do not express a preference for screening.  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening last accessed 6 July 2022

The USPSTF recommends against PSA-based screening for prostate cancer in men 70 years and older.

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening last accessed 6 July 2022

What Works

APPROACH TO SCREENING

Shared decision-making — Engage in shared decision-making about prostate cancer screening wth your physician. Although the randomized trials of screening all have important methodological limitations, the best available evidence suggests that screening confers a small absolute benefit for reducing prostate cancer mortality and the risk of developing metastatic disease. However, the potential harms from screening that arise from false-positive tests (eg, prostate biopsy, anxiety, overdiagnosis, and treatment complications) are common. (See 'Benefits and harms of screening' )

Shared decision-making is important because it is not appropriate for clinicians to determine how a patient should weigh these potential outcomes. Patients are encouraged to decide for themselves whether the benefits of screening outweigh the harms. Patients and clinicians should engage in shared decision-making when initially discussing screening as well as during subsequent screening discussions (whether the patient has agreed or declined to be screened in the past) [7,27,31-37]. 

Online patient decision aids are available at American Cancer Society (ACS)American Society of Clinical Oncology (ASCO), and US Centers for Disease Control and Prevention (CDC).

Source: https://www.uptodate.com/contents/screening-for-prostate-cancer#:~:text=(See%20'Shared%20decision%2Dmaking,age%2065)%20%5B31%5D.  Last accessed 08/29/2022

Challenges

Patients who choose to be screened with a PSA test are much more likely than those who decline PSA screening testing to be diagnosed with prostate cancer.

  • Many prostate cancers detected by screening are considered "overdiagnosed," meaning that they never would have caused problems during a man's lifetime. Most men with prostate cancer will die from other causes, not from prostate cancer.
  • No available tests can accurately determine which men with a prostate cancer found by screening have a cancer that is destined to cause health problems and would be most likely to benefit from aggressive treatment.
  • Surgery and radiation therapies are the treatments most commonly offered to try to cure prostate cancer. These treatments can lead to problems with urinary incontinence, sexual dysfunction (eg, impotence), and bowel problems (eg, diarrhea). (See 'Risks of prostate cancer therapy' .)

Source: https://www.uptodate.com/contents/screening-for-prostate-cancer#:~:text=(See%20'Shared%20decision%2Dmaking,age%2065)%20%5B31%5D.  Last accessed 08/29/2022

Corrective Action
Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy