The United States Preventive Services Task Force has officially recommended against the routine use of the PSA test to screen for prostate cancer. PSA, which stands for prostate specific antigen is a blood test. As the number rises the likelihood of an enlarged prostate or a tumor increases. The problem is that the PSA test is a poor predictor of dangerous prostate cancer. A large study of 180,000 men lasted 11 years. It found that, at best, one death from prostate cancer might be prevented by screening 1,000 men. Screening itself has some risks, because it can lead to biopsies and surgery. Erectile dysfunction and incontinence are not uncommon complications of surgery.
The American Urological Association is outraged. Many urologists believe that the PSA remains the best way to detect prostate cancer early. The task force concludes that doctors should be ready to discuss the benefits and risks of PSA tests and take patients’ preferences into account before routinely adding the PSA to a standard blood panel.
[Annals of Internal Medicine, online May 22, 2012]