JAMA Netw Open

PSA screening after age 70 offers limited mortality benefit in prostate cancer

February 19, 2025

Study details: This cohort study analyzed data from the Veterans Health Administration, focusing on men who turned 70 years old between 2008 and 2020, who had a normal PSA value (<4 ng/mL) between ages 65 and 69, and had no prior history of prostate cancer or biopsy. The study aimed to assess the 10-year risk of prostate cancer-specific mortality (PCSM) and metastatic prostate cancer (mPCa) based on PSA levels, race, ethnicity, and competing mortality risks.

Results: Of the 921,609 men, 87% continued PSA screening past age 70. The 10-year cumulative incidence of PCSM was 0.26%, with 95% of men having a risk <0.73%. Higher baseline PSA levels (3.00-3.99 ng/mL) were associated with increased PCSM risk (0.79%) compared with lower PSA levels (0.20-0.99 ng/mL, 0.10%). Black men and those with higher competing mortality risks also had elevated PCSM and mPCa risks.

Clinical impact: Continuing PSA screening after age 70 offered limited benefit in reducing prostate cancer mortality, particularly for men with low baseline PSA levels. Screening decisions should be personalized based on baseline PSA levels and overall health status.

Source:

Chung DH, et al. (2025, February 3). JAMA Netw Open. Prostate Cancer Mortality in Men Aged 70 Years Who Recently Underwent Prostate-Specific Antigen Screening. https://pubmed.ncbi.nlm.nih.gov/39951264/