D’Amico risk groups with a separate group for M+ disease at diagnosis. RESULTS: In total 10732 and 9035 men were diagnosed and 539 and 733 men died of PCa in the S and C arm res. The slope of the regression line of the ln(RR) incidence on ln(RR) mortality for all risk groups (figure 1) and for the high and metastatic risk groups (figure 2) were 1.07 (95%CI 0.86-1.28) and 1.08 (95%CI 0.85-1.31) respectively, indicating a near direct correlation between changes in PCa incidence and mortality. In total 82% and 89% of the changes in mortality could be explained by changes in incidence in all, and the high and M+ risk groups res., leaving only a small amount to be explained by other factors (e.g. treatment differences or simple chance). Sensitivity anal- ysis showed similar results. CONCLUSIONS: We show a strong association between dif- ferences in PCa incidence per risk group (stage shift) and differences in PCa mortality. Although this analysis cannot show direct causal relations, results undoubtedly support the hypothesis that PSA screening reduced PCa mortality by detecting cancer at an earlier stage and grade at which point curative treatment can still be suc- cessfully offered. Source of Funding: Most funding was obtained from national cancer research funding agencies, European funding in the form of Framework programmes, some private sponsors, and an unconditional grant of the former Beckman/Hybritech company. PD09-02 PROSTATE CANCER SCREENING AND REFERRAL PATTERNS IN THE YEARS SURROUNDING THE UNITED STATES PREVENTATIVE SERVICES TASK FORCE RECOMMENDATION AGAINST PSA SCREENING IN ALL MEN Ryan Hutchinson, Abdulhadi Akhtar*, Justin Haridas, Deepa Bhat, Claus Roehrborn, Yair Lotan, Dallas, TX INTRODUCTION AND OBJECTIVES: In May 2012 the United States Preventative Services Task Force released final recommenda- tions against prostatic-specific antigen (PSA) screening in all men. There have been conflicting reports regarding the impact of this recommendation on behavior of primary care providers (PCPs). We analyzed real-world whole-institution data on PSA incorporating actual patient demographics. METHODS: Between 2010 and July 2015 there were 275,784 all-specialty unique ambulatory visits in men. PCPs ordered 17,315 PSA tests and 858 urology referrals. PSA orders were corrected for annual patient volume. Use of PSA and urologic referral were analyzed while stratifying for patient characteristics. Linear and quadratic regression analyses were performed. RESULTS: Over the time period, number of PSAs ordered per ambulatory visit, referrals per ambulatory visit, age of patient at time of urologic referral and proportion of PSAs drawn outside of recom- mended age range did not significantly change. PSA value at time of referral increased significantly on linear (p ¼ 0.022) and quadratic (p ¼ 0.002) growth models. When analyzed by decade of life, no significant change was seen in PSAs ordered by age or in by-age referral proportion. CONCLUSIONS: In the years surrounding the USPSTF recommendation, PSA ordering by institutional primary care providers did not change significantly. Patients receiving urologic referral were referred at progressively higher average PSA levels. The implications for prostate cancer outcomes from these trends warrant further research. Source of Funding: None PD09-03 USPSTF PSA SCREENING GUIDELINES RESULT IN HIGHER GLEASON SCORE DIAGNOSES Glen Gejerman*, Patrick Ciccone, Martin Goldstein, Vincent Lanteri, Burton Schlecker, John Sanzone, Michael Esposito, Sergey Rome, Michael Ciccone, Eric Margolis, Robert Simon, Yijun Guo, Bloomfield, NJ; Sri Ram Pentakota, Newark, NJ; Hossein Sadeghi-Nejad, Bloomfield, NJ INTRODUCTION AND OBJECTIVES: In order to evaluate the impact of the 2011 United States Preventive Services Task Force (USPSTF) PSA screening guidelines on the diagnosis of prostate cancer, we compared the incidence and distribution of new cases diagnosed in 2011-before the USPSTF PSA screening recommenda- tions, with those in 2014, at which time the guidelines were widely adopted. e234 THE JOURNAL OF UROLOGY â Vol. 195, No. 4S, Supplement, Friday, May 6, 2016