Figure 1
Prostate-specific antigen (PSA) screening rates over time by age group (per 1000 men). (A) Rates of PSA screening overall. (B) Rates of screening among men eligible for a test once a year. (C) Rates of elevated PSA tests (PSAs > age-specific reference range; per 1000 men). The blue line represents the age group of 40-49 years. The red line represents the age group of 50-64 years. The green line represents the age group of 65-74 years. The purple line represents the age group of ≥years. (Color version available online.)
The rate of elevated PSA tests that were above the corresponding age-specific reference range remained constant over time among men aged 40-49 and 50-64 years, decreased in men aged 65-74 years, and sharply decreased in men aged ≥75 years beginning in 2008 (Fig. 1C). In 2012, the highest rate of elevated PSA tests was among men aged 65-74 years (45.38), followed by men aged ≥75 years (29.09), men aged 50-64 years (22.63), and finally, men aged 40-49 years (4.49) (Fig. 1C).
The prostate biopsy rate among men with an elevated PSA higher than the age-specific reference range before biopsy are shown in Figure 2. The overall rates of biopsies after an elevated PSA test increased over time for all age groups before 2009, when they began to decrease for all men younger than 75 years and remained constant for men aged ≥75 years. Although the absolute biopsy rates over time were lowest among the men aged ≥75 years, the overall percent increase over time was greatest (51.7%). In 2012, men aged 50-64 years had the highest rate of biopsy after an elevated test (314.9), and men aged ≥75 years had the lowest rate (151.3; Fig. 2).