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Drop in PSA Screening Linked to Increase in Metastatic Prostate Cancer

TUESDAY, Feb. 16, 2021 -- Reductions in prostate-specific antigen (PSA) screening are associated with increases in the incidence of metastatic prostate cancer at diagnosis, according to a study presented at the American Society of Clinical Oncology annual Genitourinary Cancers Symposium, held virtually from Feb. 11 to 13.

Vidit Sharma, M.D., from the University of California Los Angeles, and colleagues examined longitudinal variations in PSA screening and their associations with the incidence of metastatic prostate cancer at diagnosis across individual states from 2002 to 2016.

The researchers found that the percent of men older than 40 years who reported ever receiving PSA screening varied significantly between states (range, 40.1 to 70.3 percent), as did the age-adjusted incidence of metastatic prostate cancer at diagnosis (range, 3.3 to 14.3 per 100,000). The mean percentage of men screened decreased from 61.8 to 50.5 percent from 2008 to 2016, while the mean incidence of metastatic prostate cancer at diagnosis increased (6.4 to 9.0 per 100,000). There was an association noted between longitudinal reductions across states in PSA screening and increased metastatic prostate cancer (regression coefficient per 100,000 men, 14.9). Larger increases in the incidence of metastatic prostate cancer at diagnosis were seen in states with larger reductions in PSA screening. Twenty-seven percent of the longitudinal variation in metastatic prostate cancer within states was explained by variation in PSA screening.

"The magnitude of decreased PSA screening was correlated to the magnitude of increased metastatic disease, suggesting that there may be a link at population level," Sharma said in a statement.

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