What Every Man Should Know About Prostate Cancer Screening

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What Every Man Should Know About Prostate Cancer Screening

Experts share information about the PSA screening for prostate cancer, including an explanation of new guidelines.

What Every Man Should Know About Prostate Cancer Screening

Prostate-specific antigen (PSA)-based screening for prostate cancer has long been controversial. With guidelines changing on a regular basis and experts disagreeing over its use, determining whether or not to get tested can be confusing. Arming yourself with a better understanding of the issues can guide your decision-making process.

The Risks of Prostate Cancer Screening

Prostate cancer screening involves a blood test to measure the level of PSA, a protein released by a man’s prostate gland. An elevated PSA can indicate prostate cancer, but can also be a sign of several harmless conditions. Such false-positive results can create alarm and cause many men to undergo unnecessary biopsies, which put them at risk of bleeding, infection, or other complications.

Another risk with PSA screening, which helps identify prostate cancer early on, is overdiagnosis. Often, prostate cancer grows so slowly that many men diagnosed with it are more likely to die of other causes before the cancer becomes fatal. But an elevated PSA test may lead them to undergo early, and probably unnecessary, treatment. Surgery and radiation, the mainstays of prostate cancer treatment, can have serious side effects, including erectile dysfunction and urinary incontinence (leakage).

Effects of a New Guideline

That’s why, in 2012, the U.S. Preventive Services Task Force recommended against routine PSA-based screening for men of all ages, concluding that the benefits did not outweigh the harms. Two new studies published in The Journal of the American Medical Association show that this recommendation has had its intended effect: fewer men are indeed being screened and, therefore, fewer men are being diagnosed with early-stage prostate cancer. But is this good news?

The Task Force was on to something, but perhaps reacted too strongly. Addressing issues with PSA screening by rejecting it altogether has ended up minimizing the seriousness of prostate cancer. Prostate cancer still kills more than 27,500 American men every year. Reducing the number of biopsies and unnecessary treatments is a good clinical goal, but not looking for cancer at all is not the answer.

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