Beck V, et al. - In a large tertiary care center, authors gauged the changes over the last 12 years in clinical data and pathological attributes of prostatectomy specimens of prostate cancer (PCa) patients as possible consequence of lower acceptance of prostate-specific antigen (PSA)-based screening and implementation of active surveillance as a therapeutic option in PCa. Median number of positive biopsy cores increased from 3 to 5, and median PSA increased from 7 to 9 ng/ml. The proportion of patients with Gleason score ≥ 7 in biopsy specimens increased from 40 to 78% and in prostatectomy specimens from 49 to 89%. The rate of locally advanced (≥ pT3a) tumors increased from 28% to 43% and lymph node-positive tumors from 5% to 16%. They noted a probability that these changes were associated with a lower acceptance of PSA-based screening and the use of active surveillance as a management strategy and that it would have significant effect on daily patient care.