RESEARCH ARTICLE


Prevalence and Predictors of Routine Prostate-specific Antigen Screening in Medicare Beneficiaries in the USA: Retrospective Cohort Analysis Using Machine Learning



Ashis Kumar Das1, *, Saji Saraswathy Gopalan2
1 Department of Health Nutrition and Population, The World Bank Group, Washington, D.C., USA
2 Development of Global Health, London School of Hygiene and Tropical Medicine, London, England


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Creative Commons License
© 2019 Das and Gopalan.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Health Nutrition and Population, The World Bank Group, 1818 H St NW, Washington, D.C., USA; E-mail: adas8@worldbank.org


Abstract

Objective:

To estimate the prevalence and predictors of Prostate-Specific Antigen (PSA) screening among Medicare beneficiary men using machine learning algorithms.

Methods:

A retrospective cohort analysis used the Medicare Current Beneficiary Survey Public Use File (MCBS PUF) data from 2015 and 2016. Predictors of PSA screening were examined through multivariable logistic regression and machine learning techniques.

Results:

Over half (56%) of Medicare beneficiary men had PSA screening during 2015-2016. Ages between 65 and 75 years, education above high school, being married, higher annual income (>$25,000), being overweight or obese, and more than 20 outpatient office visits were significant predictors.

Conclusion:

PSA screening uptake was 56 percent among Medicare beneficiaries and it was driven by beneficiaries’ age, education, marital status, income, body mass index, and number of outpatient visits. Although Medicare provides free annual PSA screening, uptake was higher among high-income beneficiaries. Awareness strategies would help inform privileges for PSA screening under Medicare and the advantages of routine screening for mitigating the health risks.

Keywords: Prostate cancer screening, Preventive care, Medicare, USA, Artificial intelligence, Machine learning, Deep learning.