Don’t perform prostate-specific antigen (PSA) testing for prostate cancer screening in men with no symptoms of the disease when they are expected to live less than 10 years.
|Rationale and Comments:||Since PSA levels in the blood have been linked with prostate cancer, many doctors have used repeated PSA tests in the hope of finding “early” prostate cancer in men with no symptoms of the disease. Unfortunately, PSA is not as useful for screening as many have hoped because many men with prostate cancer do not have high PSA levels, and other conditions that are not cancer (such as benign prostate hyperplasia) can also increase PSA levels. Research has shown that men who receive PSA testing are less likely to die specifically from prostate cancer. However when accounting for deaths from all causes, no lives are saved, meaning that men who receive PSA screening have not been shown to live longer than men who do not have PSA screening. Men with medical conditions that limit their life expectancy to less than 10 years are unlikely to benefit from PSA screening as their probability of dying from the underlying medical problem is greater than the chance of dying from asymptomatic prostate cancer.|
|References:||• Raghavan D. PSA – Please Stop Agonizing (over prostate-specific antigen interpretation). Mayo Clin Proc. 2013 Jan;88:1-3.
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