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Prostate-specific antigen (PSA) screening is used widely. In a recent meta-analysis of randomized trials, however, researchers found that PSA screening for prostate cancer, with or without digital rectal examination, does not lead to fewer deaths due to prostate cancer or other causes (JW Gen Med Oct 7 2010). Might a focused screening strategy be more effective? In this population-based case-control study that involved nearly 1200 men, investigators assessed the relation between a single measure in 1981 of PSA concentration at age 60 and subsequent diagnosis of clinically relevant prostate cancer (metastatic disease by age 85 or prostate cancer–related death).
Overall, 43 cases of metastatic prostate cancer and 35 prostate cancer–related dea…