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Life expectancy after primary treatment for localized prostate cancer is long, so the importance of functional outcomes and quality-of-life measures cannot be underestimated. Careful assessment of the data, with an emphasis on patient selection, definition of clinical significance, and length of follow-up duration, is essential.
Increased evidence that prostate-cancer-specific mortality can be reduced using serum PSA screening, in addition to the increasing role of active surveillance in reducing overtreatment underlies the revised USPSTF recommendation, which now supports selective use of PSA testing. However, this recommendation should not be interpreted as a license to return to the unthinking use of PSA testing of men between 50 to 70 years of age.