Incidence of Early Stage Prostate Cancer Lower After USPSTF Recommendation Against PSA Testing

Incidence of Early Stage Prostate Cancer Lower After USPSTF Recommendation Against PSA Testing
Incidence of Early Stage Prostate Cancer Lower After USPSTF Recommendation Against PSA Testing

Incidence rates of early stage prostate cancer in men age 50 years and older declined substantially from 2011 to 2012, coinciding with a decline in prostate-specific antigen (PSA) testing in this age group between 2010 and 2013. The decline in PSA testing followed the US Preventive Services Task Force (USPSTF) recommendation against routine testing in all men.1

For this study, researchers obtained incidence data for invasive prostate cancer diagnoses in men 50 years and older from 18 Surveillance, Epidemiology, and End Results (SEER) registries, representing approximately 28% of the US population. Diagnoses were made between 2005 and 2013.

SEER summary stage categorized prostate cancer cases in this study as local/regional or distant stage. Using SEER*Stat software, delay-adjusted incidence rates were calculated by age (50 years and older, 50 to 74 years, 75 years and older), stage (all stages, local/regional, distant), and race/ethnicity (all races, non-Hispanic whites, non-Hispanic blacks). 

Results of this study demonstrated a significant decrease in localized/regional-stage prostate cancer incidence per 100,000 men ages 50 to 74 years (from 356.5 in 2012 to 335.4 in 2013; IR. 0.94; 99% CI, 0.92-0.96) and 75 years and older (from 379.2 in 2012 to 353.6 in 2013; IR, 0.93; 99% CI, 0.89-0.97).

However, incidence rates for distant-stage disease did not change in both age groups of men in the same period: from 15.7 to 16.5 (IR, 1.05; 99% CI, 0.96-1.15) in men 50 to 74 years and from 65.8 to 66.4 (IR, 1.01; 99% CI, 0.91-1.12) in men 75 years and older. Similar results were seen among non-Hispanic whites and non-Hispanic blacks.

Reference

1. Jemal A, Ma J, Siegel R, Fedewa S, Brawley O, Ward EM. Prostate cancer incidence rates 2 years after the US Preventive Services Task Force recommendations against screening [Research Letter]. JAMA Oncol. 2016 Aug 18. doi: 10.1001/jamaoncol.2016.2667. [Epub ahead of print]

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