Screening for prostate cancer with a PSA test is no longer recommended for men, according to revised guidelines published by a government panel. After reviewing the current research, the panel found that the benefits of testing for PSA—or prostate-specific antigen—do not outweigh the risks.
The revised policy, published in the Annals of Internal Medicine, extends the recommendation against PSA testing to all men. In 2008, when the U.S. Preventive Services Task Force (USPSTF) last published its guidelines for prostate cancer screening, it had advised against the use of PSA testing in men over 75.
While prostate cancer can kill, the number of men who die from the disease is actually low. One study found that 28 percent of men in their sixties were diagnosed with prostate cancer based upon high PSA levels, but only three percent eventually died from it.
Complications from treatments prompted by PSA testing, however, result in the death of 1,000 to 1,300 men a year. Treatment options for prostate cancer include surgery, radiation, and androgen deprivation therapy.
In addition to the risk of death, treatment can cause incontinence and impotence. Prostate biopsies can also lead to pain, fever, infection, bleeding, or problems urinating.
Not all doctors, including the American Urologic Association, are pleased with the change. "Men who are in good health and have more than a 10-15 year life expectancy should have the choice to be tested and not discouraged from doing so," according to the AUA.
The new recommendations, however, do suggest that doctors discuss possible PSA testing with patients on an individual basis, if warranted. This should include recognition of the risks and benefits of prostate cancer screening.