Prostate Specific Antigen Screening in Texas Medicare Population: The Role of Patient Characteristics

The objectives of this study were to 1) determine the prevalence of prostate specific antigen (PSA) testing in the Texas Medicare population and 2) assess which patient characteristics are associated with receipt of PSA screening. The 100% Texas Medicare claims data and 2009 population estimates from the Dartmouth Institute were used to examine temporal trends in PSA testing from 2000-2009. Chi Square statistics and logistic regression were used to estimate the association between patient characteristics and the likelihood of receiving a PSA test. PSA testing rates increased steadily in the Texas Medicare population from 2001-2007, without major changes in 2008-2009. Among the 449,976 men in the study population, 46.8% received a PSA test. PSA testing rates were lower in Blacks compared to Whites (OR .64; 95% CI: 0.63-0.66) and those in age group categories 76-80 (OR .88; 95% CI: .86-.89) and 81-85 (OR .66; 95% CI: 0.64-0.67). PSA testing rates increased as median income at zip code level (quartile) increased. Beneficiaries with one or two comorbidities were more likely to receive a PSA test compared to those with none. No association was found between rural/ urban area and PSA testing. This analysis may provide clinicians with more information on how to optimize PSA testing and increase its benefit in the Texas Medicare population.