Inappropriate PSA Screening Common in VA Hospitals

Many physicians ignore recommendation against screening asymptomatic men over age 75

MONDAY, July 9 (HealthDay News) -- Many physicians do not follow evidence-based guidelines for prostate-specific antigen (PSA) screening, according to a report in the July 9 issue of the Archives of Internal Medicine.

B. Price Kerfoot, M.D., of Harvard Medical School in Boston, and colleagues studied 1997-2004 data from the Veterans Health Administration on 181,139 patients at seven hospitals and the 4,823 health care providers who ordered their tests.

The researchers found a mean percentage of inappropriate tests by health care providers of 18.4 percent in patients older than age 75 and 0.8 percent in patients younger than age 40. They also found that urologists, male physicians, those who infrequently order tests and physicians affiliated with specific hospitals were more likely to order inappropriate tests. They also found that older male physicians were especially likely to order inappropriate tests.

"How can the current levels of inappropriate PSA screening be reduced? Improving patient knowledge about PSA screening is an important first step," the authors write. "Systems-level changes may also be an effective method by which to improve PSA screening practices. For example, a computerized ordering system could alert practitioners when they attempt to order a PSA test on an age-inappropriate patient."

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