PSA screening has made a dramatic difference to when prostate cancer is diagnosed. At the start of my career, many men were first diagnosed only when there disease was already widespread. Now I'm pleased to say this is now a much less common occurrence. Welch et al "Trends in Metastatic Breast and Prostate Cancer — Lessons in Cancer Dynamics" N Engl J Med 2015; 373:1685-1687. http://www.nejm.org/doi/full/10.1056/NEJMp1510443?af=R&rss=currentIssue