Background: Routine prostate cancer screening is controversial, yet the use of prostate-specific antigen (PSA) for screening is likely to continue. Our hospital laboratory decreased the cutoff for normal PSA to 2.5 ng/mL on July 2, 2007, based on the National Comprehensive Screening Network recommendations. The purpose of this study was to determine if referral rates to urology increased after this change.Methods: We queried our electronic health records to obtain the number of total screening PSA and abnormal PSA and subsequent referrals to urology in the 20-month periods before and after the change in PSA cutoff.Results: There was no significant difference between the percentage of total screening PSA that resulted in a referral to urology after the change than before (7 of