No surprise here, IMO. This is like saying what if I had that PSA 19 years ago when I was 50, and then never had another one. There I was a future G9, but no sign of anything to worry about
back then. So I would expect that only a minority of men with fatal PC brewing inside would be found by a single PSA. Unlike that ever rising trend over years that I had. So if a single PSA is unlikely to point to a need for treatment except in that minority of men who happen to be pretty far along when they get that 1st PSA, I would expect very few to be detected and thus get needed treatment early, which might result in living longer. Does this study actually tell us anything useful? https://edhub.ama-assn.org/jn-learning/module/2673968
Findings In this randomized clinical trial comparing men aged 50 to 69 years undergoing a single PSA screening (n = 189 386) vs controls not undergoing a PSA screening (n = 219 439), the proportion of men diagnosed with prostate cancer was higher in the intervention group (4.3%) than in the control group (3.6%); however, there was no significant difference in prostate cancer mortality (0.30 per 1000 person-years for the intervention group vs 0.31 for the control group) after a median follow-up of 10 years.
Meaning The single PSA screening intervention detected more prostate cancer cases but had no significant effect on prostate cancer mortality after a median follow-up of 10 years.
PSA 10.9 ~112013
Bx on 112013 at age ~65yrs, with 5 of 12 pos, G9(5+4), T2B.
RALP with lymph nodes at Vanderbilt 021914. (nodes clear, SV+, G9 down graded to 4+5, 1 focal margin )
only rare pad use after 1 year
PSA <.01 on 6/14 and all until 9/15 = .01, still .01 9/16, .02 on 3/17,6/17,10/17, .06 1/18, .06 4/18, <.05 7/18, .06 10/1