Increase in prostate cancer screening after rollout of revised national guidelines

In May 2018, the US Preventive Services Task Force (USPSTF) published new prostate cancer screening guidelines, which had last been updated in 2012. The updated recommendations advise against prostate-specific antigen (PSA) based screening for prostate cancer in men aged 55 years and older, instead endorsing individual-based screening for men aged 55 to 69 years only. This decision was based on research that found the benefits of screening in older men did not outweigh the potential risks. In a recent study published in JAMA Oncology by Leapman and colleagues, an increase in prostate cancer screening was observed following revisions to the USPSTF recommendations. GlobalData epidemiologists expect that the results of this study may indicate a future increase in diagnosed incident cases of prostate cancer in the US due to the rise in screening uptake.

In the study by Leapman and colleagues, a retrospective cohort study was conducted on more than eight million Blue Cross Blue Shield insured patients between 2016 and 2019; study participants included men aged 40 to 89 years. Study findings showed a 12.5% total increase in PSA testing in men aged 40 to 89 years from 2016 to 2019. More specifically, significant changes were observed among patients aged 55 to 69 years, with a 12.1% increase (in which screening is advised by the guideline), but also among those aged 40 to 54 years, with a 10.1% increase. Men aged 70 years or older saw a 16.2% increase (in which screening is not advised by the guideline). Overall, an increase in screening was observed across all age groups, and was not only limited to the recommended screening age groups.

This year in the US, GlobalData epidemiologists forecast more than 183,000 diagnosed incident cases of prostate cancer, with this expected to increase to more than 204,000 by 2028 in men aged 40 years and older. But if the increase in screening uptake observed in the study by Leapman and colleagues is any indication, there may be a significant increase in the detection of diagnosed incident cases of prostate cancer across all age groups over the next five years that will likely surpass current forecast estimates. While Leapman and colleagues highlight important trends in screening uptake, more research is needed to fully understand and quantify these increases, especially in age groups that are not recommended for screening by the USPSTF. In the future, researchers should focus on conducting larger, multi-centre studies to better understand and elaborate on the findings from this study.