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The U.S. Preventive Services Task Force (USPSTF) recommended against routine screening for prostate cancer with prostate-specific antigen (PSA) testing in 2008 for older men (age, ≥75; NEJM JW Gen Med Sep 15 2008 and Ann Intern Med 2008; 149:192) and in 2012 for all men (NEJM JW Gen Med Jul 1 2012 and Ann Intern Med 2012; 157:120). These changes prompted investigators to explore trends in the incidence of distant metastatic prostate cancer using data from a representative subset of a national cancer registry. Cases were identified from 2004 to 2018 to account for delays in effects of the USPSTF changes.
Of 836,000 total cases of prostate cancer, 3.2% and 2.5% were cases of distant metastatic cancer in middle-aged (age range, 45–74) and older…