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Regardless of their personal opinions on prostate cancer screening, primary care clinicians continue to see patients who request prostate-specific antigen (PSA) testing or who get tested in the community. European studies have suggested that middle-aged patients with very low initial PSA results are unlikely to develop lethal prostate cancer (NEJM JW Gen Med Jun 1 2014 and BMJ 2014; 348:g2296). Now, this issue is addressed in a multiethnic U.S. study that involved about 3000 men (mean age, 58) who underwent PSA screening every 1 to 2 years.
During follow-up, for as long as 12 years (median follow-up, 7.4 years), 10% of participants were diagnosed with prostate cancer. At baseline, half the men had PSA levels ≤1.0 ng/mL; 10-year risk of recei…