Men:  Benefit and Harms of PSA Screening for Prostate Cancer

Information

The United States Preventive Services Task Force (USPSTF) has analyzed the data from the PLCO, ERSPC, and other trials.  It is estimated that for every 1,000 men ages 55 to 69 years who are screened every 1 to 4 years for a decade*.

*: Moyer VA on behalf of the U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine 2012; 157(2):120–134

Key Points

  • The PSA test measures the blood level of PSA, a protein that is produced by the prostate gland. The higher a man’s PSA level, the more likely it is that he has prostate cancer. However, there are additional reasons for having an elevated PSA level, and some men who have prostate cancer do not have elevated PSA.
  • The PSA test has been widely used to screen men for prostate cancer. It is also used to monitor men who have been diagnosed with prostate cancer to see if their cancer has recurred (come back) after initial treatment or is responding to therapy.
  • Some advisory groups now recommend against the use of the PSA test to screen for prostate cancer because the benefits, if any, are small and the harms can be substantial. None recommend its use without a detailed discussion of the pros and cons of using the test.
Benefits and Harms of Prostate Cancer Antigen (PSA)Screening in Men
  • 0 to 1 death from prostate cancer would be avoided.
  • 100 to 120 men would have a false-positive test result that leads to a biopsy, and about one-third of the men who get a biopsy would experience at least moderately bothersome symptoms from the biopsy.
  • 110 men would be diagnosed with prostate cancer. About 50 of these men would have a complication from treatment, including erectile dysfunction in 29 men, urinary incontinence in 18 men, serious cardiovascular events in 2 men, deep vein thrombosis or pulmonary embolism in 1 man, and death due to the treatment in less than 1 man.

An infographic illustrating the benefit and harms of PSA screening for prostate cancer.

Source: NIH/NCI

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