Changing clinical trends in 10 000 robot‐assisted laparoscopic prostatectomy patients and impact of the 2012 US Preventive Services Task Force's statement against PSA screening

Objectives To evaluate the clinical trend changes in our robot‐assisted laparoscopic prostatectomy (RALP) practice and to investigate the effect of 2012 US Preventive Services Task Force (USPSTF) statement against PSA screening on these trends. Patients and Methods Data of 10 000 RALPs performed by a single surgeon between 2002 and 2017 were retrospectively analysed. Time trends in successive 1000 cases for clinical, surgical and pathological characteristics were analysed with linear and logistic regression. Time‐trend changes before and after the USPSTF's statement were compared using a logistic regression model and likelihood‐ratio test. Results Unfavourable cancer characteristics rate, including D'Amico high risk, pathological non‐organ‐confined disease and Gleason score ≥4+4 increased from 11.5% to 23.3%, 14% to 42.5%, and 7.7% to 20.9%, respectively, over time (all P