Supplementary Material for: Prostate Cancer Characteristics in the US Preventive Services Task Force Grade D Era: A Single-Center Study and Meta-Analysis

<b><i>Background:</i></b> In May 2012, the US Preventive Services Task Force assigned prostate-specific antigen-based screening a grade D recommendation, advising against screening at any age. Our objective was to compare prostate cancer characteristics pre- and post-recommendation with an adjusted analysis of our data and a pooled analysis including other primary data sources. <b><i>Methods:</i></b> We identified all incident prostate cancer diagnoses at our institution from 2007 to 2016. Multivariable log binomial regression was used to determine the relative risk (RR) of metastasis at diagnosis, ≥Gleason Group 4, and high D’Amico risk disease pre- versus post-recommendation. The meta-analysis included primary data studies evaluating these outcomes. <b><i>Results:</i></b> At our institution, 287 (44.6%) and 224 (48.8%) patients were diagnosed in the pre- and post-cohorts. The RR of metastatic disease at diagnosis did not differ between groups (<i>p</i> = 0.224), nor did the risk of high D’Amico category disease (<i>p</i> = 0.089). The risk of ≥Gleason Group 4 was 1.58 times higher post-recommendation (<i>p</i> = 0.007). The pooled risk of ≥Gleason Group 4 disease was 1.5 (<i>p</i> &lt; 0.001) post-recommendation and was 1.29 (<i>p</i> = 0.006) for high D’Amico risk disease. <b><i>Conclusions:</i></b> While the number of metastatic cases did not differ after the recommendation, the risk of high-grade cancers increased at both a local and aggregated level.