{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:33:20Z","timestamp":1792611200123,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T00:00:00Z","timestamp":1572912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["2 (CDA 12\u2013171)"],"award-info":[{"award-number":["2 (CDA 12\u2013171)"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R37 CA222885"],"award-info":[{"award-number":["R37 CA222885"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01 HS18726"],"award-info":[{"award-number":["R01 HS18726"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although prostate\u2010specific antigen (PSA) testing is used for prostate cancer detection and posttreatment surveillance, thresholds in these settings differ. The screening cutoff of 4.0\u00a0ng\/mL may be inappropriately used during postsurgery surveillance, where 0.2\u00a0ng\/mL is typically used, creating missed opportunities for effective salvage radiation treatment. We performed a study to determine whether guideline concordance with annual postoperative PSA surveillance increases when PSA values exceed 4\u00a0ng\/mL, which represents a screening threshold that is not relevant after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used US Veterans Health Administration data to perform a retrospective longitudinal cohort study of men diagnosed with nonmetastatic prostate cancer from 2005 to 2008 who underwent radical prostatectomy. We used logistic regression to examine the association between postoperative PSA levels and receipt of an annual PSA test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 10\u00a0400 men and 38\u00a0901 person\u2010years of follow\u2010up, annual guideline concordance decreased from 95% in year 1 to 79% in year 7. After adjustment, guideline concordance was lower for the youngest and oldest men, Black, and unmarried men. Guideline concordance significantly increased as PSA exceeded 4\u00a0ng\/mL (adjusted odds ratio 2.20 PSA\u00a0&gt;\u00a04\u20106\u00a0ng\/mL vs PSA\u00a0&gt;\u00a01\u20104\u00a0ng\/mL, 95% confidence interval 1.20\u20104.03;<jats:italic>P<\/jats:italic>\u00a0=\u00a0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Guideline concordance with prostate cancer surveillance increased when PSA values exceeded 4\u00a0ng\/mL, suggesting a screening threshold not relevant after prostate cancer surgery, where 0.2\u00a0ng\/mL is considered treatment failure, is impacting cancer surveillance quality. Clarification of PSA thresholds for early detection vs cancer surveillance, as well as emphasizing adherence for younger and Black men, appears warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.2663","type":"journal-article","created":{"date-parts":[[2019,11,6]],"date-time":"2019-11-06T03:35:42Z","timestamp":1573011342000},"page":"7903-7912","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association between PSA values and surveillance quality after prostate cancer surgery"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8513-5398","authenticated-orcid":false,"given":"Christina Hunter","family":"Chapman","sequence":"first","affiliation":[{"name":"Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor MI USA"},{"name":"Department of Radiation Oncology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1597-5428","authenticated-orcid":false,"given":"Megan E. V.","family":"Caram","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor MI USA"},{"name":"Division of Hematology\/Oncology Department of Internal Medicine University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Tsodikov","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4846-6486","authenticated-orcid":false,"given":"Curtiland","family":"Deville","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins University Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Burns","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Zaslavsky","sequence":"additional","affiliation":[{"name":"Department of Urology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Chang","sequence":"additional","affiliation":[{"name":"Hunter Holmes McGuire Veterans Affairs Healthcare System Department of Radiation Oncology Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T.","family":"Leppert","sequence":"additional","affiliation":[{"name":"Center for Innovation to Implementation Veterans Affairs Palo 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