PSA Screening

In this week's JAMA:

If practice were evidence-based, PSA screening would be less common among men than colorectal cancer screening, a preventive service of broad acceptance and proven efficacy.

The article is a review of data collected on men between 40 and 50. Since the evidence for PSA testing remains less than compelling, one would expect that colorectal cancer screening would be more common, since it's darn clear that it saves lives.

Not so. 75% of men had PSA tests vs 63% with colorectal screening.

Hmm .. after some struggle with our EMR, I can say that the practice in my office (3 physicians) reflects the evidence quite well. Greater than 70% colorectal screening .. and less than 50% PSA.

Having ths discussion about PSA testing is challenging. Here's a nice little handout from across the pond.