Low-Value Prostate-Specific Antigen Test for Prostate Cancer Screening and Subsequent Health Care Utilization and Spending

Key Points Question To what extent is an initial low-value prostate-specific antigen (PSA) test for prostate cancer screening associated with subsequent health services utilization and costs? Findings In this cross-sectional study of 995 442 men aged 70 years and older, 38% received a low-value PSA cancer screening between 2016 and 2018, and more than half received follow-up services, with repeated PSA testing being the most common. For every $1 spent on a low-value PSA cancer screening, an additional $6 was spent on follow-up care. Meaning In this study, low-value PSA screening for prostate cancer increased from 2016 to 2018 and was associated with unnecessary expenditures due to avoidable care cascades, despite multiple guidelines recommending against its routine use in men aged 70 years and older.

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