Introduction Prostate cancer screening using prostate‐specific antigen (PSA) testing remains widespread. The prevalence of PSA testing in young men is unknown and may be an appropriate target for improving health care by decreasing low‐value testing in this age group. The purpose of this study was to determine PSA testing rates in men younger than current guidelines support. Materials and Methods Health Informational National Trends Surveys (HINTS) from 2011 to 2014 and 2017 were analyzed to establish the prevalence of PSA testing in young men and to evaluate the differences in testing rates based on race. Results The combined survey data included 5178 men, with 2393 reporting previous PSA screening. Of men ages 18–39, 7% recalled receipt of PSA testing. Twenty‐two percent of men between the ages of 40 and 44 had been tested. Among men under age 40, PSA testing was more common among black men (14%) compared to white men (7%), Hispanics (6%), and men of Asian descent (8%). Logistic regression modeling demonstrates that black men under the age of 40 were more likely to undergo PSA testing than other racial or ethnic groups (odds ratio 2.14; 95% CI 1.17, 3.93). Conclusions Current guidelines do not recommend routine PSA testing in average‐risk men under the age of 40. This study found that a significant number of young men are exposed to testing, with the greatest risk among black men. This suggests that there is an opportunity to improve the value of PSA testing by decreasing testing in young men.

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status, highest PIRADS lesion on MRI and final biopsy pathology were collected. Cancer Detection Rate (CDR), clinically significant Cancer Detection Rate (csCDR), and clinically significant cancer detection rate in target only (csCDRt) were compared by technique type. Statistical analysis was performed using Chi-squared, Fisher's exact, and t-tests as appropriate.RESULTS: A total of 377 TRUSUN and 118 TPCF prostate biopsies were performed. TPCF detected more cancers of any grade (p[0.02), but there was no difference in csCDR or csCDRt. When stratified by lesion, there was no difference in cancer detection except in the PIRADS 5 group, where TPCF outperformed TRUSUN biopsy in detecting clinically significant prostate cancer (p[0.006). Further analysis of the PIRADS 5 group found no difference in baseline characteristics except for age (mean age 72.2y in TP group, 68.7y in TRUS p[0.008).CONCLUSIONS: TPCF prostate biopsy showed similar rates of csCDR and csCDRt as TRUSUN prostate biopsy. When analyzed by PI-RADS score, TPCF was found to have similar or, in the case of PI-RADS 5 lesion, superior csCDRt. Subgroup analysis did not find significant group differences, aside from age, to explain this finding. This data suggests that TPCF is as effective at detecting clinically significant prostate cancer as TRUSUN.

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