Association of PSA screening rates with subsequent metastatic prostate cancer incidence at Veterans Health Administration facilities

There is controversy about the benefit of PSA screening. A retrospective cohort study of men aged 40 years or older receiving care at one of 128 Veterans Health Administration facilities between 2005 and 2019 found that from 2015 to 2019, PSA screening rates decreased from 47.2% to 37.0%. Facilities with higher PSA screening rates had lower subsequent rates of metastatic prostate cancer, while facilities with higher long-term nonscreening rates had higher metastatic prostate cancer incidence 5 years later.