PSA screening
| Prostate cancer screening | |
|---|---|
| Medical diagnostics |
Prostate cancer screening is an attempt to identify individuals with prostate cancer in a broad segment of the population—those for whom there is no reason to suspect prostate cancer. There are currently[update] two methods used: One is the digital rectal examination (DRE), in which the examiner inserts a gloved, lubricated finger into the rectum to examine the adjoining prostate. The other is the prostate-specific antigen (PSA) blood test, which measures the concentration of this molecule in the blood.
The United States Preventive Services Task Force (USPSTF) in 2012 recommended against PSA screening for all ages finding that the potential risks outweigh the potential benefits. A draft proposal in 2017 includes recommendations against PSA screening in those over 70 years old and individualizing the decision to screen in those 55 to 70.
Guidelines from the American Urological Association, and the American Cancer Society recommend that men be informed of the risks and benefits of screening. The American Society of Clinical Oncology recommends screening be discouraged in those who are expected to live less than ten years, while in those with a life expectancy of greater than ten years a decision should be made by the person in question based on the potential risks and benefits. In general, they conclude that based on recent research, "it is uncertain whether the benefits associated with PSA testing for prostate cancer screening are worth the harms associated with screening and subsequent unnecessary treatment."
Prostate cancer can develop into a fatal, painful disease, but it can also develop so slowly that it will never cause problems during the man's lifetime. It is difficult for a physician to determine how the cancer will proceed based on screening tests currently available alone.
The United States Preventive Services Task Force (USPSTF) recommended against PSA screening in healthy men finding that the potential risks outweigh the potential benefits. This October 2011 recommendation is based on a review of evidence and concludes that "prostate-specific antigen–based screening results in small or no reduction in prostate cancer–specific mortality and is associated with harms related to subsequent evaluation and treatments, some of which may be unnecessary."
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