New research out of California has revealed a concerning rise in prostate cancer diagnoses in recent years — a trend experts link to shifts in national screening recommendations.
A study conducted by researchers at UC San Francisco (UCSF), and published in JAMA, analyzed data from nearly 388,000 men diagnosed with prostate cancer between 2004 and 2021. The findings showed that between 2011 and 2021, prostate cancer cases in California increased by an average of 6.7% annually.
While the number of cases is rising, the mortality rate tells a more complex story. Deaths from prostate cancer declined steadily — by about 2.6% per year — from 2004 to 2012. But after that, from 2012 through 2021, mortality rates leveled off. These patterns were consistent across demographic groups, including different ages, races, ethnicities, and regions within California.
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Researchers say this uptick in cases likely corresponds with a controversial change in national screening practices. In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended against routine PSA (prostate-specific antigen) screening for prostate cancer, citing concerns that it led to overdiagnosis and overtreatment of slow-growing, non-aggressive tumors.
According to UCSF, prostate cancer is the most frequently diagnosed cancer in men and ranks second in cancer-related deaths. However, many prostate tumors are classified as low-risk and often never spread or cause harm. The PSA test, while effective at detecting abnormalities, cannot distinguish between slow-growing and aggressive cancers — resulting in treatments for some men that may not have been necessary.
Still, UCSF researchers caution that a lack of screening comes with its own dangers. “Without early detection, there’s a greater chance of diagnosing prostate cancer only after it has progressed to an advanced stage, when treatment options are more limited and less effective,” the study notes.
In fact, researchers say the pause in widespread PSA screening may have played a role in what appears to be one of the most significant increases in distant stage prostate cancer diagnoses in recent decades.
“These findings highlight the need for smarter, more selective screening tools that can detect life-threatening cancers while avoiding unnecessary intervention for those that pose little risk,” said Dr. Erin L. Van Blarigan, the study’s lead author and an associate professor at UCSF.
Fox News medical analyst Dr. Marc Siegel, who was not part of the research, echoed these concerns. “I was never in favor of the move away from PSA testing,” he said. “With the advancement of MRI and other tools, not every elevated PSA has to mean a biopsy — but eliminating screening altogether wasn’t the answer.”
Siegel also pointed to other factors that could be contributing to the rise in prostate cancer cases, such as rising obesity rates, poor dietary habits involving ultra-processed foods, and increased alcohol consumption.
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Dr. David R. Wise, an oncologist with NYU Langone Health who was also not involved in the study, said California’s recent trends mirror national data. “We’re seeing a real increase in metastatic prostate cancer diagnoses that aligns with the drop in screenings during the 2010s,” he said. “Resuming screening could help reverse this trend.”
Wise emphasized that modern screening methods, such as MRI and newer blood-based biomarker tests, are making it possible to better target aggressive cancers while sparing low-risk patients from unnecessary treatments.
As research continues, both UCSF and independent experts agree that finding the right balance in prostate cancer screening — one that prioritizes early detection without over-treatment — remains a critical challenge.
