Choosing Wisely:

Don’t routinely perform PSA-based screening for prostate cancer.

Rationale and Comments: More than 1,000 symptom-free men need to be screened for prostate cancer to save one additional life. As a result, increased harms and medical costs due to widespread screening of asymptomatic men are believed to outweigh the benefits of routine screening. There is a high likelihood of having a false-positive result, leading to worry, decreased quality of life, and unnecessary biopsies when many of these elevated PSAs are caused by enlarged prostates and infection instead of cancer. This recommendation pertains to the routine screening of most men. In rare circumstances, such as a strong family history of prostate and related cancers, screening may be appropriate.
Sponsoring Organizations:
  • American College of Preventive Medicine
  • Sources:
  • USPSTF/ACPM/ACP guidelines
  • Disciplines:
  • Urologic
  • Oncologic
  • Preventive Medicine
  • References: • Lim LS, Sherin K; ACPM Prevention Practice Committee. Screening for prostate cancer in U.S. men ACPM position statement on preventive practice. Am J Prev Med. 2008;34(2):164-70.
    • Moyer; U.S Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157(2):120-34.
    • Qaseem A, Barry MJ, Denberg TD, Owens DK, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Screening for prostate cancer: a guidance statement from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2013;158(10):761-9.

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