Most men do not need to undergo routine testing for prostate cancer because the benefit of doing so is small and uncertain, and there are harms associated with the testing, according to an international panel.
The prostate-specific antigen (PSA) test is the most widely used one to screen for prostate cancer. It is controversial as it has led many men to get additional testing and prostate biopsies, but with questionable benefit. Up to 50% of men that get a biopsy as a result of a positive PSA test will have cancer that never grows, spreads or harms them. And many men who get treated experience incontinence and sexual dysfunction as a result.
The panel, which is made up of doctors, researchers and men at risk of prostate cancer, made its recommendation based on a review of clinical trials involving more than 700,000 men. It found that if the screening reduces prostate cancer deaths at all, the effect is quite small.
However, they caution that men at high risk – those with a family history of prostate cancer and those of African descent – may want to consider the PSA screening with their doctor.
In May, the US Preventive Services Task Force released its own recommendation on prostate cancer screening. It says that for men between 55 and 69, the decision should be “an individual one” based on a discussion of the test’s benefits and harms with their clinician. “Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men,” the recommendation states.
For men 70 and older, a PSA test was not recommended.