I have had a number of questions regarding prostate screening and in particular the PSA test. All of the organizations emphasize the considerable controversy surrounding screening due to the lack of conclusive evidence that screening can reduce mortality (death) from prostate cancer. All of the groups also address the clear potential that screening may increase treatment-related morbidity (side effects). The groups agree that there is insufficient evidence to recommend routine screening for prostate cancer in any age group, and that the decision to undergo screening should be an individualized, informed decision on the part of the patient in consultation with his physician.
There is overall agreement that clinicians should inform men of the potential benefits, known risks (including overdetection and overtreatment), as well as the limits/gaps in current evidence. These factors, in conjunction with the patient’s personal preferences and age/life expectancy, should be taken into consideration in the collaborative decision-making process.
If the decision to screen is made, there is overall agreement that while the PSA test is more sensitive than the DRE (digital rectal examination), the DRE is useful and should be performed as well.
Confused? What this means is that we do not have a good test for prostate cancer and the tests we have may lead to complications. If you are a male over 45, have a family history of prostate cancer or have changing urinary symptoms it is recommended that you discuss the issues with your Doctor.