---

It is unknown whether decreases in the prevalence of prostate-specific antigen (PSA) screening and prostate cancer incidence rates, following the US Preventive Service Task Force (USPSTF) recommendations against routine PSA, are similar across socioeconomic groups and US census regions.

We analyzed incidence rates and PSA screening prevalence by age, race/ethnicity, disease stage, US region, and area-level socioeconomic status. Annual percent changes were examined for changes in rates over time. Predicted marginal probability and 95% confidence intervals (CI) were calculated to estimate changes in PSA screening.

Incidence rates for men age ≥50 years decreased in all race/ethnic, regional, and SES groups. From 2007-2013, overall incidence rates for localized cancers significantly decreased by 7.5% (95% CI; -10.5, -4.4) per year in age 50-74 years and by 11.1% (95% CI; -14.1, -8.1) per year in age ≥75 years. In contrast, incidence for distant-stage cancer significantly increased by 1.4% (95% CI; 0.3, 2.5) per year from 2008-2013 in age 50-74 years, but stabilized from 2011-2013 in age ≥75 years (5.1% per year, 95% CI; -3.4, 14.4). Distant-stage disease rates increased with increasing poverty-level in age 50-74, but not in age ≥75 years.

Prostate cancer incidence decreased for early-stage disease in men 50 years and older, while rates for distant-stage disease slightly increased in men 50-74 years following USPSTF recommendations against routine PSA screening. Further studies with additional years of data are needed to substantiate our findings and monitor the effects of late stage disease increase on prostate cancer mortality rates.

Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

PMID:28965781