Facts:
1). USPSTF is ALONE in their recommendation against PSA screening. All others (AUA, NCCN, ACS, etc) recommend shared decision making
2.) The 40% mortality drop is attributed to PSA screening
3.) The drop in the rate of metastasis is attributed to PSA screening
4.) If PSA screening ends, expect mortality and incidence of metastatic disease to rise, which would be catastrophic
5.) PLCO (American) Trial was a comparison of less vs more intense PSA screening, NOT A SCREENING TRIAL, and can be ignored as such
6.) European trial showed a mortality benefit
7.) If you want to make a MASSIVE IMPORTANT impact, do not reimburse for prostatectomy, radiation therapy, or any form of treatment for low risk prostate cancer. This would be an important paradigm shift that would force providers to embrace active surveillance (they are already doing so, but this would be a real kick in the pants)

Not covering PSA screening would be a public health bumble of epic proportions, the effects of which would take several years to realize.

PSA screening is flawed, but it can be done better (appropriate biopsy thresholds, active surveillance for low risk cancer), so that those with intermediate and high risk (real) prostate cancer can still be identified and treated.