ArticleUrology2026
Divergent Trends in Prostate-specific Antigen Screening Prior to Testosterone Therapy in Younger vs Older Men Amidst Shifting Guidelines.
Article in Urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo assess whether prostate-specific antigen (PSA) testing rates prior to testosterone replacement therapy (TTh) differed by age (40-54 vs 55-69), race, and guideline era (2009-2012 vs 2013-2022).
methodsWe performed a retrospective cohort study using the TriNetX Research Network, including men aged 40-69 who received TTh for hypogonadism between 2009 and 2022. The primary outcome was PSA screening within 1 year before TTh. Analyses were performed after 1:1 propensity score matching by age, race, ethnicity, and clinical characteristics.
resultsAmong 74,463 men, 12.2% of those aged 40-54 and 18.6% of those aged 55-69 were screened within 1 year of TTh initiation. For men aged 40-54, rates did not differ across eras (11.5% vs 12.2%). In men aged 55-69, screening increased significantly in 2013-2022 (16.8% vs 19.5%). Overall pre-TTh screening rates did not differ by race; however, Black men aged 40-54 had higher odds of screening than White men.
conclusionDespite longstanding recommendations, PSA screening prior to TTh remains low, particularly in younger and high-risk men. Shifting guidelines may contribute. These findings underscore the need for education and targeted strategies to improve prostate cancer risk assessment before TTh.
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