The PSA blood test was used for annual prostate cancer screenings until about 2008, when scientists learned more about its benefits and harms. A controversy bloomed as experts tried to determine whether the benefits of annual prostate cancer screenings outweighed the risks.
[9]
The main issue is that a PSA blood test cannot differentiate between benign (noncancerous) and malignant (cancerous) tissue. Therefore, a high PSA test result could cause considerable unnecessary anxiety, if the man doesn’t have prostate cancer.
[4]
Additionally, many slow-growing prostate cancers may not need treatment, which can cause side effects such as impotence, incontinence, and bowel issues.[2]
[10]
In 2012, the U.S. Preventive Services Task Force (USPSTF), an independent panel of experts that makes evidence-based recommendations about clinical preventive services, found little benefit and significant harm associated with routine PSA blood tests to screen for prostate cancer. It subsequently recommended against these tests.
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The USPTF updated its recommendation in 2018 to reflect new evidence of the benefits of PSA screenings on prostate cancer death rates. For men 55 to 69 years old, it recommends making a joint decision with your doctor about whether to undergo periodic PSA screening, after discussing the risks and benefits of screening.
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The USPSTF recommends against prostate cancer screening in men over 70, but the NCCN suggests that at this age, screening could be considered if the person is expected to live for at least another 10 years.
[5]
[12]
Many other professional healthcare organizations, associations, and societies have similar recommendations for prostate cancer screening.
PSA testing is thought to lower cancer mortality rates, and the mortality rate of prostate cancer has significantly declined over the past 30 years.
[13]
[14]
