|The following article features coverage from the American Society of Clinical Oncology (ASCO) 2019 meeting.|
US Preventive Services Task Force (USPSTF) recommendations against PSA screening for prostate cancer (PCa) have been followed by significantly more diagnoses of advanced PCa, according to study findings presented at the 2019 American Society of Clinical Oncology annual meeting in Chicago.
In 2008, USPSTF recommended against PSA screening for men aged 75 years or older, and in 2012, this recommendation was expanded to include all men.
Using the Surveillance, Epidemiology and End Results (SEER) database, Iris Yeong-Fung Sheng, MD, and colleagues at Cleveland Clinic identified 603,323 men in the age group 55 to 69 years diagnosed with PCa from 2004 to 2015. The investigators stratified patients based on year of diagnosis: 2004 to 2008 (group 1, 262,240 men), 2009 to 2012 (group 2, 210,045 men), and 2012 to 2015 (group 3, 131,038 men), and categorized PCa stage as nodal (N1M0) and metastatic (NxM1) and
In group 1, 1.4% of men had N1M0 and 2.8% had NxM1 cancer. The proportions of these stages were 1.6% and 3.7% in group 2, and 1.4% and 6.1% in group 3.
Compared with group 2 (reference), group 1 had significant 22% decreased odds of being diagnosed with stage N1M0 or NxM1 in adjusted analyses, whereas group 3 had significant 71% increased odds of being diagnosed with these disease stages, the investigators reported in a poster presentation.
A subgroup analysis of PCa patients not eligible for the study inclusion—those younger than 55 and older than 70 years—showed similar stage migration, according to the investigators.
Sheng IYF, Chen YW, Ornstein MC, et al. Implications of the United States Preventive Services Task Force (USPSTF) recommendations on prostate cancer (PCa) stage migration. Presented at the 2019 American Society of Clinical Oncology annual meeting in Chicago, May 31 to June 4. Abstract 5071.