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Incidence of Metastatic Prostate Cancer in Older Men Increases Following Drop in PSA Screening

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The incidence of metastatic prostate cancer in older men is rising after reaching an all-time low in 2011, according to new research from Weill Cornell Medicine and NewYork-Presbyterian investigators.

The findings suggest a correlation between the increase and a change in prostate cancer screening guidelines recommending against routine prostate-specific antigen (PSA) testing.

In their study, published Dec. 29 in JAMA Oncology, the investigators used a national cancer database to identify 545,399 men over the age of 40 who were diagnosed with prostate cancer between 2004 and 2013. They found that in men over 75, both the incidence of metastatic prostate cancer and the proportion of men with aggressive cancer increased since 2011. The researchers say their results may reflect the downstream effects of the U.S. Preventative Services Task Force’s (USPSTF) recommendations against routine PSA tests, and underscore the need for healthcare policy leaders to reevaluate their approach to prostate cancer screenings.

“It’s what most of us would have predicted, although somewhat sooner,” said lead author Dr. Jim Hu, the Ronald P. Lynch Professor of Urologic Oncology at Weill Cornell Medicine and director of the LeFrak Center for Robotic Surgery at NewYork-Presbyterian Weill Cornell Medical Center, who conducted the study in collaboration with co-senior author Dr. Art Sedrakyan, a professor of healthcare policy and research at Weill Cornell Medicine.

“There was a decrease in prostate cancer metastasis and death after the advent of PSA testing. Remove the screening and the rates of serious disease rise again.”

Read more about their research and its findings here.