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Recent changes in prostate cancer screening practices and prostate cancer epidemiology.


AUTHORS

Lee DJ , Mallin K , Graves AJ , Chang SS , Penson DF , Resnick MJ , Barocas DA , . The Journal of urology. 2017 5 25; ().

ABSTRACT

Prostate-specific antigen (PSA) based screening for prostate cancer has had a significant impact on the epidemiology of the disease. Its use has been associated with a significant reduction in prostate cancer mortality, but has also resulted in the overdiagnosis and overtreatment of indolent prostate cancer, exposing many men to the harms of treatment without benefit. The U.S. Preventive Service Task Force (USPSTF) issued a recommendation against screening men over 75 in 2008, and against routine screening for all men in 2012, indicating that, in their interpretation, the harms of screening outweigh the benefits. Herein, we review the changes in use of PSA testing, changes in the use of prostate biopsy, and changes in the incidence of prostate cancer and stage at presentation since 2012.


Prostate-specific antigen (PSA) based screening for prostate cancer has had a significant impact on the epidemiology of the disease. Its use has been associated with a significant reduction in prostate cancer mortality, but has also resulted in the overdiagnosis and overtreatment of indolent prostate cancer, exposing many men to the harms of treatment without benefit. The U.S. Preventive Service Task Force (USPSTF) issued a recommendation against screening men over 75 in 2008, and against routine screening for all men in 2012, indicating that, in their interpretation, the harms of screening outweigh the benefits. Herein, we review the changes in use of PSA testing, changes in the use of prostate biopsy, and changes in the incidence of prostate cancer and stage at presentation since 2012.


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