Getting Tested for Prostate Cancer May Be Worth It After All

“The controversy over PSA-based screening should no longer be whether it can do good,” wrote Andrew Vickers, from Memorial Sloan Kettering Cancer Center, in an editorial accompanying the study, “but whether we can change our behavior so that it does more good than harm.”

 Should Men Screen for Prostate Cancer? Biden Diagnosis Reignites Debate

Guidelines have gone back and forth over years on whether men should be screened at all

 The pros and cons of PSA tests for prostate cancer for midlife and older men

Attempts to balance the possible harms against the number of lives saved have led to two decades of fluctuating – and confusing – public health guidelines on PSA screening. In 2012, the U.S. Preventive Services Task Force advised against any screening, only to issue a watered-down recommendation in 2018 that men ages 55 to 69 discuss screening with their health care providers. Various physicians' groups offer conflicting guidance for this age group. In its advice to older men, however, the U.S. Preventive Services Task Force has been somewhat more consistent. In 2008, the independent panel of national experts recommended men 75 and older not be screened, and since 2018, the panel has advised against screening men 70 and older.

Current PSA-Screening Recommendations

This recommendation replaces the 2012 USPSTF recommendation on PSA-based screening for prostate cancer... Men aged 55 to 69 y - The decision to be screened for prostate cancer should be an individual one. Men 70 y and older - Do not screen for prostate cancer.

Biden, Peter Attia & the PSA Controversy — What You’re Not Being Told

In this episode, Dr. Lee Kurisko of Kurisko & Co. dives into the complex and often misunderstood topic of prostate cancer screening. Prompted by President Joe Biden’s recent diagnosis and insights from Dr. Peter Attia’s Instagram video on this very topic, Dr. Kurisko presents data that challenge the prevailing assumptions around routine PSA testing. While early detection is commonly promoted, the evidence reveals a more nuanced reality: screening can sometimes do more harm than good. From overdiagnosis to unnecessary treatments, Dr. Kurisko makes the case for informed consent as the foundation of any screening decision. He also underscores the impact of a WFPB diet in the prevention and possible treatment of prostate cancer.

Cancer Screening Can Do More Harm Than Good

Catching cancer early doesn't always increase a patient's longevity and wellbeing.

Confronting A Controversy- The PSA Question

There is no question that PSA screening can detect prostate cancer about 6 years earlier than a digital rectal exam and 5 to 10 years before symptoms of the disease are recognized. And statistics show that the prostate cancer mortality rate in the US has declined more than 40 percent since the early 1990s, when PSA screening became widespread. But several large studies conducted to validate and quantify the effects of PSA screening have yielded divergent conclusions and strikingly different interpretations of the data on the part of physicians and scientists.

Men and PSA: To Test or Not To Test?

There are different guidelines for PSA screening. The American Cancer Society suggests that “average risk” men (without a family history, without African American descent) who are interested in screening should start at age 50 and conclude at age 75. For men at higher risk, these guidelines recommend earlier screening, at ages 40 to 45. However, there is no “one size fits all” approach for prostate cancer screening, and it is important to discuss the risks, benefits, and timing with your doctor. Guidelines also discourage further screening for men at average risk between ages 70 and 75. That is because PSA is less effective and dependable in older men, who are more likely to die from another issue in the ensuing 10 to 15 years.

Men concerned about prostate cancer should think before asking for a PSA test

Retired urologist Reginald Hall says men should consider the evidence before asking their GP for the screening test.

More men diagnosed with advanced prostate cancer as PSA screening declines

The rise in cases of deadly prostate cancer may be partly linked to recommendations against prostate-specific antigen, or PSA, screening for healthy men, experts suggest.

Myths About PSA Tests and Prostate Cancer Screening

“Over the past few decades, many hundreds of thousands of American men have been diagnosed and treated for prostate cancer that never would have become apparent if not for PSA testing,” Dr. Vickers says. “But the amount of overdiagnosis and overtreatment depends on how the test is used. If screening guidelines based on more up-to-date knowledge are followed and treatment is limited to aggressive cancers, the number of men being unnecessarily diagnosed with and treated for prostate cancer can be dramatically reduced.”

New study once again casts doubt on PSA screening

To screen or not to screen for prostate cancer? This remains an important question. Screening relies on a highly imperfect measure, the prostate-specific antigen (PSA) blood test, which is prone to false-positive results. And with mounting evidence that survival benefits from screening pale in comparison with the harms from overtreatment — particularly incontinence and impotence — the pendulum has steadily swung away from it. Still, screening research continues, in the hopes that some lifesaving benefits may be found. Now the latest study once again casts doubt on PSA screening as an effective public health tool.

New study once again casts doubt on PSA screening

To screen or not to screen for prostate cancer? This remains an important question. Screening relies on a highly imperfect measure, the prostate-specific antigen (PSA) blood test, which is prone to false-positive results. And with mounting evidence that survival benefits from screening pale in comparison with the harms from overtreatment — particularly incontinence and impotence — the pendulum has steadily swung away from it. Still, screening research continues, in the hopes that some lifesaving benefits may be found.

Older Men Are Still Being Overtested for Prostate Cancer

For 75-year-olds still running marathons, the test might make sense. For most others, it probably doesn’t.

Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis

At best, screening for prostate cancer leads to a small reduction in disease-specific mortality over 10 years but has does not affect overall mortality. Clinicians and patients considering PSA based screening need to weigh these benefits against the potential short and long term harms of screening, including complications from biopsies and subsequent treatment, as well as the risk of overdiagnosis and overtreatment.

PSA testing for prostate cancer is only worth it for some

A recent UK study showed no significant difference in survival between men who had a single prostate-specific antigen (PSA) test – a blood test used to detect prostate cancer – and those who didn’t, after about ten years of follow-up. This was despite the test being responsible for more prostate cancers being diagnosed.

PSA Testing-What Every Man Needs to Know

It is important to emphasize that the PSA test is not a specific prostate cancer test, but it is a vital first step in screening for the potential presence of cancer.

Talking to Men About PSA Testing

Why is it so hard for doctors to change how they approach the test? Partly it’s because the pros and cons of PSA testing are so difficult for doctors to explain to patients.

What to Know If the Doctor Says to Skip Your Prostate Cancer Screening

If you’re still not convinced, ask your doctor about two new tests, phi and PCA3, both of which represent incremental improvements on PSA testing. Neither of these has been FDA-approved for PCa screening, and insurers are unlikely to pick up the tab. But if you’re willing to pay hundreds of dollars out-of-pocket, your doctor might agree to try one on you. Just don’t expect definitive answers, only marginally less murky ones than those provided by PSA.

Why a one-off PSA test for prostate cancer is doing men more harm than good

The potential for blood tests that detect cancer is huge. But what if a test is, in some ways, too good? What if it finds cancers that if left undetected wouldn’t cause a person any harm? And what if it’s not possible to know for certain which cancers need to be treated, or who could avoid a life-altering diagnosis and potential long-term treatment side effects? This is the situation right now with prostate cancer. There’s no UK screening programme for prostate cancer. That’s because the blood test that would be used – called the PSA (or prostate specific antigen) test – isn’t reliable enough. Men over the age of 50 with no symptoms of prostate cancer can still ask for the test in the UK. But its use is hotly debated around the world.