What Happens to Older Men After PSA Screening?

Amid the controversy surrounding use of prostate-specific antigen (PSA) testing to screen for prostate cancer, this longitudinal cohort study of PSA screening in 300,000 men (age, ≥65; mean age, 73; 90% white) in the Veterans Affairs (VA) health system provides some new perspectives of what happens in actual clinical practice. Men received PSA screening in 2003 and were followed for 5 years.

Of 25,208 patients with PSA levels >4.0 µg/L, 33% underwent prostate biopsies; of those with PSA levels >6.5 µg/L, 39% underwent biopsies; and, of those with PSA levels >10.0 µg/L, 42% underwent biopsies. Of men who underwent biopsies, 5220 (63%) were diagnosed with prostate cancer; of these, 4284 were treated with radical prostatectomy, radiation therap…