O-116 The ‘Stage Shift’ effect: evaluating the impact of decentralized PSA screening on downward stage migration of prostate cancer in Guyana (2024–2025)

Methods: Study design: retrospective program evaluation using aggregated screening and diagnostic data from the Guyana Men’s Health Unit (MHU), over the years 2024- 2025. Target population: Guyanese men aged 45-75 years, and high-risk men were screened at 40 years. Sampling: men who voluntarily participated and and were prescribed PSA in both private and public hospitals. Procedures and data sources: Registered private labs and government laboratories conducting PSA.

Results: PSA tests increased by 78.6 % in 2025 (n=24,665) compared to 2024 (n=13,800). Elevated PSAs in 2024 (n=2,600) vs 2025 (n=4,270), of which 646 (2025) biopied compared to 536 in 2024. In 2024, 38% of biopsies were positive; and the same in 2025, 38%. Sixty per cent (60%) of the positive cancer cases diagnosed in 2025 were in Stage 1 & 2, compared to 39% (2024). Afro Guyanese men were mainly affected. A ratio persists over the 2024–2025 period of 1:5 of prostate cancer to elevated PSA, with statistical significance, p-value 0.00017. This sample was years younger than the previous sample, while the pattern persisted.

Conclusion: The PSA screening initiative contributes to a significant “stage shift” toward earlier diagnoses in Guyana, directly improving patient prognosis and reducing mortality and morbidity. While the number of people being screened is good, follow-up is needed to ensure all men with high PSA levels receive timely, reviews. This successful downstaging offers valuable lessons for other Caribbean nations in designing and implementing effective, primary care-led programs for prostate cancer screening.