title: The effect of the USPSTF PSA screening recommendation on prostate cancer incidence patterns in the USA.
abstract: Guidelines regarding recommendations for PSA screening for early detection of prostate cancer are conflicting. In 2012, the United States Preventive Services Task Force (USPSTF) assigned a grade of D (recommending against screening) for men aged ≥75 years in 2008 and for men of all ages in 2012. Understanding temporal trends in rates of screening before and after the 2012 recommendation in terms of usage patterns in PSA screening, changes in prostate cancer incidence and biopsy patterns, and how the recommendation has influenced physician's and men's attitudes about PSA screening and subsequent ordering of other screening tests is essential within the scope of prostate cancer screening policy. Since the 2012 recommendation, rates of PSA screening decreased by 3-10% in all age groups and across most geographical regions of the USA. Rates of prostate biopsy and prostate cancer incidence have declined in unison, with a shift towards tumours being of higher grade and stage upon detection. Despite the recommendation, some physicians report ongoing willingness to screen appropriately selected men, and many men report intending to continue to ask for the PSA test from their physician. In the coming years, we expect to have an improved understanding of whether these decreased rates of screening will affect prostate cancer metastasis and mortality.
authors.affiliation: Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond Street, London, Ontario N6A 5C1, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Fleshner
authors.affiliation: Department of Surgery and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, New York 10017, USA.|Institute of Clinical Sciences, Department of Urology, Sahlgrenska Academy at the University of Gothenburg, Bruna Stråket 11B, 41345 Göteborg, Sweden.
authors.forename: Sigrid V
authors.initials: SV
authors.lastname: Carlsson
authors.affiliation: Department of Urology, Erasmus Medical Center, office Na-1706, Wytemaweg 80, 3015 CN Rotterdam, Netherlands.
authors.forename: Monique J
authors.initials: MJ
authors.lastname: Roobol
mesh_terms: D026683:Advisory Committees / Q000592:standards*; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards*; D006801:Humans; D015994:Incidence; D008297:Male; D017410:Practice Guidelines as Topic / Q000592:standards*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
chemical_list: D017430:Prostate-Specific Antigen