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Since the introduction of prostate-specific antigen (PSA) measurement into clinical practice in the late 1980s, managing patients with prostate cancer has changed dramatically, especially in the U.S. Use of androgen-deprivation therapy (in many instances, for patients with rising PSA levels only) has increased substantially. Patients with disease identified only by high PSA levels have substantially longer survival than do patients with overt metastatic disease, which results in prolonged exposure to this therapy. Moreover, additional problems, such as therapy-related osteoporosis, now are recognized.
U.S. researchers conducted an observational study of a population-based cohort of 73,196 Medicare enrollees (age, ≥66; mean age, 74) with loco…