Key result
The 2018 USPSTF guideline shift fails to reverse the ~6% annual rise in distant-stage prostate cancer.
Why the study?
Guideline changes discouraging routine PSA screening raised concern for later-stage prostate cancer presentation, but few analyses have evaluated whether the 2018 transition to shared decision-making affected stage-specific incidence through 2022.
Does the 2018 USPSTF guideline modification to shared decision-making affect the stage-specific incidence of prostate cancer in men aged ≥55?
Population
Men aged ≥55 diagnosed with malignant prostate cancer in SEER 17 Registries
Comparison
Localized vs distant prostate malignancies across guideline eras (2000–2022)
Design
Population-based registry Joinpoint regression analysis
Authors
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Persistent rise in distant-stage prostate cancer after 2018 guidelines supports vigilant monitoring; leaves open optimal screening strategies in observational data.
Observational
Yes
Does the 2018 USPSTF guideline modification to shared decision-making affect the stage-specific incidence of prostate cancer in men aged ≥55?
Effect estimate: APC +6.04% (distant, 2010-2022)
p-value: p=<0.05
The 2018 USPSTF shift to shared decision-making for prostate cancer screening has not yet reversed or slowed the rising incidence of distant-stage prostate cancer that followed earlier recommendations against routine screening.
Noah Ritschard (2026) conducted an observational in Prostate cancer. 2018 USPSTF guideline modification (shared decision-making) vs. Prior time periods was evaluated on Annual Percent Change (APC) in age-adjusted incidence rates of localized and distant prostate malignancies (APC +6.04% (distant, 2010-2022), p=<0.05). The 2018 USPSTF guideline shift to shared decision-making for PSA screening has not reversed the rising incidence of distant-stage prostate cancer, which increased from 2010–2022 (APC +6.04%; p<0.05).
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