Prostate Cancer - Screening

Screening

Prostate cancer screening is an attempt to find unsuspected cancers, and may lead to more invasive follow-up tests such as a biopsy, with cell samples taken for closer study. Options include the digital rectal exam (DRE) and the prostate-specific antigen (PSA) blood test. Such screening is controversial and, in some people, may lead to unnecessary, even harmful, consequences. Routine screening with either a DRE or PSA is not supported by the evidence as there is no mortality benefit from screening.

The United States Preventive Services Task Force (USPSTF) recommends against the PSA test for prostate cancer screening in healthy men regardless of age. The USPSTF concludes that the potential benefit of testing does not outweigh the expected harms, "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." The Centers for Disease Control and Prevention shared that conclusion. The American Society of Clinical Oncology (ASCO) 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.