Ahlering T, et al. - Authors evaluated the impact of decreased prostate-specific antigen (PSA) screening on the presentation of high-risk prostate cancer post-radical prostatectomy (RP). Consistent decreases of low-grade disease and absolute increases in intermediate and high-risk cancer were experienced in all centers. The more aggressive disease was demonstrated by propensity matching in the post-recommendation era for any given age and PSA. Significant increases in pathologic stage, grade, and lymph node involvement was seen in forest plots of odds ratios adjusted for age and PSA.