A study, Analysis of Surveillance, Epidemiology, and End Results (SEER), has shed light on the increased prevalence of incidence of distant metastasis at diagnosis in men aged ≥75 years with prostate cancer. This increase is most probably the result of a recommendation provided by the US Preventative Services Task Force (USPSTF), which was to do away with screening for prostate cancer in men ≥75 years old in 2008 and against screening in men of any age in 2012. From the SEER data, 1,107,111 men ≥40 years old diagnosed between 2004 and 3013 with pathologically confirmed prostate cancer were identified. The incidence of distant metastasis was derived using SEER collaborative staging at quarterly intervals. Between 2004 and 2013, the proportion of men aged ≤75 years presenting with distant metastasis increased from 2.7% to 4.0% and the proportion presenting with intermediate-risk or high-risk disease increased from 46.3% to 56.4%. Over the same time period, the proportion of men aged ≥75 years presenting with distant metastasis increased from 6.6% to 12.0% and the proportion of those presenting with intermediate-risk or high-risk disease increased from 58.1% to 72.0%. The significant increase in the incidence of distant metastasis at prostate cancer diagnosis in men aged ≥75 years between 2011 and 2013 in men in could be an effect of the USPSTF 2008 recommendation against screening for prostate cancer in these men.
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