I’ve long been a skeptic of routine testing of the prostate-specific antigen, or PSA, in most men. Yes, it’s a simple little blood test, and sometimes an elevated PSA reading shows you have prostate cancer. But PSA screening most often produces a false positive result, leading to a whole host of nasty potential complications including impotence and urinary incontinence. Many men develop tiny little prostate cancers that never develop into a disease. Nevertheless, about 30,000 men die of prostate cancer each year in the United States.
The BMJ (British Medical Journal) just published a detailed review of the evidence for and against routine PSA screening and comes out strongly against it for most men. Most, not all, because screening makes sense if you’re at increased risk of real prostate cancer. This includes men whose close relative (father, brother) had prostate cancer, and certain minority groups with higher risk including African-Americans. The BMJ article is intended for health professionals and is full of statistics and medical details that could make your eyes glaze over. But it’s exceptionally clear and should be accessible to a lay audience.