While prostate-specific antigen (PSA) screening protocols vary, many clinicians have anecdotes of screened men with low PSA levels that rise significantly and are associated with high-risk prostate cancer (PC). We sought to better understand the frequency of high-risk cases that appear suddenly in a screened population.We utilized data from a Commercial and Medicare advantage claims database to identify all US men ages 50 and above undergoing PSA screening who then had a sudden interval rise in PSA (e.g., PSA?=?20) and diagnosis of PC. We determined associations with age, race, screening intensity, and baseline PSA levels.In all, 526,120 men met entry criteria with an average age of 60.7 and follow-up of 5.6?years. As the baseline PSA increased, the rate of high-risk PC increased from 2/10,000 persons among men with the lowest baseline PSA (<1?ng/ml) to 14/10,000 person-years among men with a baseline PSA?
View details for DOI 10.1002/pros.24075
View details for PubMedID 32956488