Prostate-specific antigen testing in the United States during 2008–2022 in relation to the US preventive services task force recommendations

Sep 21, 2026

Uploaded by Theodora

Prostate-specific antigen (PSA) testing rates in the United States declined from 2008 through 2020, then increased from 2020 to 2022. Using BRFSS survey data for men aged 40+ across even years, the study evaluates how trends vary by age, marital status, education, income, and health care coverage, and whether reasons for testing changed. Declines were more pronounced in younger, never-married, less-educated, and uninsured men, while racial/ethnic and income differences were not significant after adjustment. Reasons for testing largely stayed stable.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Background

Methods

Data

Results

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN Prostate-specific antigen testing in the United States during 2008–2022 in relation tothe US preventive services task force recommendations Ray M. Merrill􀀍 & Ian S. Gibbons The prevalence of prostate-specific antigen (PSA) testing has consistently fallen for several years. This study explored how the decreasing trend differs by selected variables and reasons for taking the PSA test. Analyses involved men, aged 40 years or older, who completed the Behavior Risk Factor Surveillance System (BRFSS) survey in even number years from 2008 through 2022. Trends in PSA testing rates within the past year declined by 46% from 2008 to 2020 and then increased 21% from 2020 to 2022. The greatest changes corresponded with the years of new USPSTF guidelines. Declining PSA testing rates occurred across the levels of all variables considered but were more pronounced in younger men and men never married, less educated, and without health care coverage. After adjusting for these variables, declining PSA testing rates did not significantly differ between racial/ethnic groups or between income groups. The level of several variables influenced the decline, as a function of perceived risk, accessibility, and desire for the test. Inconsistencies with the USPSTF’s guidelines were seen in higher PSA testing in older and more educated men. The distribution of main reasons for taking the test (part of a routine exam [72%], prostate problem/cancer [12%], family history [6%], and other [10%]) remained constant. PSA testing as part of a routine exam (vs. no PSA test) increased with age and was higher in non-Hispanic Blacks, married (or cohabitating), and in men with higher education, higher income, and health care coverage. PSA testing because of a prostate problem/cancer or family history of prostate cancer according to these variables are also described in this study. Keywords BRFSS, Prostate Cancer, PSA, Screening, USPSTF guidelines In 2012, the United States Preventive Services Task Force (USPSTF) guidelines recommended against using prostate-specific antigen (PSA) testing for routine prostate cancer screening for men inthe general US population because of the cancer’s low risk and high potential for over treatment1. In 2018, the guidelines were modified for men aged 55–69 years, with the decision to undergo periodic PSA testing based on an individual decision made in consultation with a clinician about the potential benefits and harms of the test2. Men aged 70 years or older were advised against PSA testing. For men less than age 55, the American Cancer Society recommends that Black men who have a first-degree relative diagnosed with prostate cancer should begin PSA testing at age 45, and those who have more than one first degree relatives with prostate cancer to begin screening at age 403. Consistent with these recommendations, a study based on the 2018 U.S. Behavior Risk Factor Surveillance System (BRFSS) survey found that about 15% of men aged 40–54 years had taken a PSA test within the past two years4. The study also showed that PSA testing was higher among Blacks than Whites in this age group4. Another study using BRFSS data found that in men aged 40–54, PSA testing was higher among Black men than White men in each of the years 2012 through 20185. The study also showed a consistent decrease in men receiving PSA testing in the past year, from 2012 to 2018, occurring for all racial/ethnic groups within the age groups 40–54, 55–69, and 70–74. With the decreasing trend in PSA testing in the U.S., it is unclear whether the reasons for taking a PSA test have changed. We might expect that taking a PSA as part of a routine exam would decrease more than other reasons (e.g., prostate problem, prostate cancer, family history of prostate cancer) because of the USPSTF Department of Public Health, College of Life Sciences, Brigham Young University, 2063 Life Sciences B

FAQs

How did PSA testing rates change between 2008 and 2022?

PSA testing rates fell by 46% from 2008 to 2020, then rose by 21% from 2020 to 2022.

Which groups showed the largest declines in PSA testing rates?

Declines were more pronounced in younger men and in men who were never married, less educated, and without health care coverage.

Did the study find differences in PSA testing trends by race/ethnicity after adjustment?

After adjusting for variables, declining PSA testing rates did not significantly differ between racial/ethnic groups.

Sep 21, 2026

Uploaded by Theodora