the value of screening. One, done in the U.S., found that annual PSA screening did not reduce men’s risk of being diagnosed with metastatic prostate cancer, or of dying from the disease.
The other trial, done in Europe, found that screening did reduce advanced cancer diagnoses.
In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended against routine PSA screening for average-risk men.
Studies since then have charted an increase in metastatic prostate cancer among U.S. men. But it has not been clear whether declines in PSA screening, and missed chances to catch early cancer, are to blame.
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The new findings suggest that declines in screening are part of the story, according to lead researcher Dr. Alex Bryant.
“I think it is likely that part of the recent increase in metastatic prostate cancer cases is due to historical declines in PSA screening,” says Bryant, a radiation oncologist at the University of Michigan Rogel Cancer Center in Ann Arbor.
But, he adds, it’s “unlikely to be the full story.”
According to the researchers, the magnitude of the increase in metastatic cancers does not appear to be explained by the change in PSA screening alone. It’s not yet clear what the other explanations might be, Bryant shares.
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Individualized screenings
The findings were published Oct. 24 in JAMA Oncology and presented Tuesday at a meeting of the American Society for Radiation Oncology, in San Antonio.
The study showed that between 2005 and 2019, VA centers’ PSA screening rates fell from about 47% to 37% — meaning the proportion of men age 40 and up who’d been screened that year.
Meanwhile, metastatic prostate cancer rates rose from roughly 5 per 100,000 men in 2005, to almost
