VA medical centers with lower PSA screening rates reported higher rates of metastatic prostate cancer, a recent retrospective analysis found. ASTRO22
But the debate regarding the value of PSA has continued.
The researchers found that PSA screening rates decreased from a high of nearly 51% in 2008 to 37% in 2019, with reductions seen across all age and race groups. Over the same period, the team observed a corresponding increase in the rates of long-term nonscreening — men who missed screenings 3 years in a row. The long-term nonscreening rate increased from a low of about 21% in 2009 to a high of 33% in 2019.
Conversely, facilities with lower yearly screening rates had higher subsequent rates of metastatic prostate cancer 5 years later . In addition, for every 10% increase in the long-term nonscreening PSA rate, there was an 11% increase in the incidence of metastatic prostate cancer 5 years later . "We don't want to come back to the day where everyone is offered screening in shopping malls, in every doctor's office, because there was this phenomenon that many patients were being diagnosed with cancers that were not really life threatening," Michalski toldBut some men, such as those with a family history of the disease or from certain ethnic or racial backgrounds,"have a higher risk of developing prostate cancer, so screening has to be targeted," he explained.
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