Variation in prostate-specific antigen screening in men aged 80 and older in fee-for-service medicare

Abstract

OBJECTIVES: To determine the rate of prostate-specific antigen (PSA) screening in men aged 80 and older in Medicare and to examine geographic variation in screening rates across the U.S. DESIGN: Retrospective cohort study of variation across hospital referral regions using administrative data. SETTING: National random sample in fee-for-service Medicare. PARTICIPANTS: Medicare beneficiaries aged 80 and older in 2003. MEASUREMENTS: Percentage of men aged 80 and older screened using the PSA test. RESULTS: The national rate of PSA screening in men aged 80 and older was 17.2%, but there was wide variation across regions (<2-38%). Higher PSA screening in a region was positively associated with greater total costs (correlation coefficient (r)=0.49, P