Plambeck BD, Wang LL, Mcgirr S, et al. - Findings demonstrate a negative impact of the 2012 USPSTF (US Preventive Services Task Force) guidelines on the pathologic outcomes post-prostatectomy. Elevated frequency of higher-risk prostate cancer (PCa) and lower frequency of favorable disease was found in patients diagnosed between 2012 and 2018 updates. Additionally, a continued negative influence on postprostatectomy pathology was shown by data after the 2018 update.

• The USPSTF prostate cancer screening guidelines were updated in May 2018 (recommended prostate cancer screening for ages 55–69 be an individual decision), and the impacts of the 2012 (recommend against screening for all ages) and 2018 updates on pathologic outcomes after prostatectomy remain unclear.

• A total of 647 PCa patients who had prostatectomy from 2005 to 2018 were divided as those diagnosed prior to the 2012 update (n = 179), between 2012 and 2018 updates (n = 417), and after the 2018 update (n = 51).

• An increase in median age from 60 to 63 between 2012 and 2018 updates and to 64 after the 2018 update was revealed.

• Between 2012 and 2018 updates, a significant decrease in pathologic Gleason grade group (pGS): pGS1, pGS2, pT2, and favorable pathology, and a significant increase in pGS3, pGS4, pGS5, pT3a, and unfavorable pathology was identified.

• Multivariable regression showed that diagnosis between 2012 and 2018 updates was significantly related to pGS4 or pGS5 and pT3a.

• Diagnosis after the 2018 update was identified to be significantly related to pT3a.

• Diagnosis between 2012 and 2018 updates and after the 2018 update was associated with 3.2× higher and 2.3× higher odds of pGS4 or pGS5, respectively.

• Overall 2.4× higher odds of pT3a were noted if diagnosed between 2012 and 2018 updates and 2.9× higher if after the 2018 update.