PSA Screening Declines Linked to Higher Rates of Advanced Prostate Cancer

By Tamara Thomas - April 22, 2023

According to a report published by the American Cancer Society, there has been an increase in advanced-stage cancer diagnoses, which is associated with a decline in prostate-specific antigen (PSA) testing.

The American Cancer Society has projected that in 2023, around 1,958,310 new cancer cases will be diagnosed in the United States, with an estimated 609,820 deaths caused by cancer. 

Notably, the incidence of prostate cancer has increased by three percent every year from 2014 to 2019, leading to the diagnosis of approximately ninety-nine thousand new cases. The researchers believe that diagnoses of advanced diseases mostly drive this increase. 

The increases are “worrisome,” said the study’s lead author, Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society. That’s because prostate cancer that has spread to distant sites beyond the organ is “extremely difficult to treat,” Siegel said. “There is no durable cure for those with metastatic disease,” she added.

Experts suggest that the rise in cases of deadly prostate cancer may be partly linked to recommendations against prostate-specific antigen screening for healthy men.

According to the latest report, Siegel and her team discovered that there has been an annual rise of four to five percent in the detection of advanced-stage prostate cancer since 2011.

“In 2019, eight percent were diagnosed at a distant stage, as compared to four percent in 2011, and fourteen percent were diagnosed at a regional stage, versus eleven percent in 2011, for a total of twenty-two advanced stages,” Siegel told NBC News.

Experts suggest that the increase in instances of fatal prostate cancer could be partially attributed to the advice against screening healthy men for prostate-specific antigen (PSA).

Prostate-specific antigen (PSA) screening for prostate cancer has been controversial due to concerns about overdiagnosis and overtreatment. In 2008, the US Preventive Services Task Force (USPSTF) opposed PSA screening for men 75 and older, and in 2012, it advised against routine screening for all men. 

In 2018, USPSTF advised men ages fifty-five to sixty-nine to make an individual choice about screening after talking with their doctors. This led to a decrease in screening and incidence. However, this study suggests that this may have resulted in more advanced prostate cancer cases being diagnosed.

Experts suggest being smarter in using imaging, minimizing biopsies, and recruiting more patients for active surveillance to reduce the trend of more advanced cases.


Source: NBC News

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