Prostate Cancer Screening

The percentage of men aged 55 to 69 years who reported having had a PSA test within the past year, by race/ethnicity, income, education level, and age. This provides information about the use of PSA testing in the population. 

Measurement challenges

We track prostate cancer screening rates in U.S. using a large, national, in-person survey in which male respondents were asked several questions about prostate cancer and PSA testing, including whether they had ever had a PSA test and, if so, the time of their most recent test and the main reason for undergoing it (see Data Source, below). There are important limitations to this method that impact what information we can accurately collect and how confident we can be in the findings. Studies have found that certain types of healthcare survey questions can be difficult for people to clearly understand and answer, and it is easy for some questions to be misinterpreted.  

In the case of PSA screening, it may be challenging to determine by self-report alone if a PSA test was received for screening purposes, i.e., to look for asymptomatic, previously undetected cancer, or for diagnostic purposes, i.e., as a follow up on symptoms or suspicious findings from a prior test. Additionally, looking for new or recurrent asymptomatic cancer in a person previously diagnosed and treated for that cancer type represents a third type of testing known as surveillance testing. In some cases, because PSA testing is a blood test, it may be bundled by a clinician with other tests, and a man may be unaware he even had the test. Finally, men may also not always accurately recall the specific time they received a particular test. As such, our measure captures any type of PSA test received by a man, and the population may include those with a prior diagnosis of prostate cancer. This serves as a reasonable approximation, although an overestimate, of the true U.S. prostate cancer screening rate.

Even though the National Health Interview Survey prostate cancer screening measures have limitations, it is the best nationally representative data we have available to assess prostate cancer screening rates.