A Decade After USPSTF Recommendations:

Research Finds Sustained Increases in Metastatic Prostate Cancer Rates

Categories: Spring 2021

Previous research has reported on the impact of the U.S. Preventive Services Task Force recommendations against PSA screening for prostate cancer in 2008 for older men and in 2012 for all men. The rates of localized prostate cancer decreased, while the rates of regional- and distant-stage prostate cancer increased.

PSA testFor example, a study published in 2019 found a “definitive and sustained” increase in prostate cancer cases with distant metastases for men 75 years and older from 2011 to 2015, and a gradual increase of younger men (ages 50 to 74) diagnosed with metastatic prostate cancer from 2007 to 2015. The study also found that rates of non-metastatic prostate cancer decreased from 2004 to 2015.

Researchers from the American Cancer Society published a study assessing whether those same patterns persisted longer, through 2016.

The study showed the incidence rate for distant-stage prostate cancer increased by 2.4% per year from 2008 to 2012. After the 2012 USPSTF recommendation against PSA screening, the incidence rate for distant-stage disease more than doubled. For example, from 2012 to 2016, the rate increased by 5.2% each year for men 75 years or older.

The authors estimated that 11,387 more men were diagnosed with distant- stage prostate cancer than if incidence rates had stayed at 2008 levels.

For localized prostate cancer, incidence decreased from 2007 to 2016 by 6.4% per year for men 50 to 74 years old, and 10.7% from 2007 to 2013 for men 75 years or older.

Thus, the USPSTF’s discouraging PSA testing appeared to increase the proportion of men with life-threatening prostate cancer diagnosed with advanced-stage disease.

Distant-stage prostate cancer has already spread from the prostate to more distant parts to the body, such as to the lungs, liver, or bones. According to the American Cancer Society, the current 5-year relative survival rate for men diagnosed with distant-stage prostate cancer is 30%, compared to nearly 100% for localized prostate cancer. Early detection is key.




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