PSA tests: When screening may cause more harm than good

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Over the past few years, prostate cancer screening using the prostate-specific antigen (PSA) test has received a lot of media flack while various health organizations and physicians struggle to outline specific guidelines for the exam.

A new study published in BMJ hopes to shed some light on the debate by suggesting that prostate cancer screening doesn’t substantially reduce the risk of death from the disease. Swedish Researchers collected 20 years of data on 9,026 men between the ages of 50 and 69 beginning in 1987, before PSA testing was available. Participants were separated into two groups, in which the first group (1,494 men) was screened for prostate cancer using a digital rectal exam (DRE) until 1993, at which point both a DRE and PSA test were used to screen every three years. The second study group (7,532) was maintained as a comparison group and did not undergo any screening. The final results showed no significant difference in the mortality rate between the two cohorts.

These findings agree with recently updated prostate cancer screening guidelines issued by the U.S. government in 2008, which are skeptical of advising PSA screenings for healthy men at any age while flatly recommending against them entirely for men over 75. “This study shows, once again, that PSA testing can actually cause more harm than good due to false-positive results that often lead to invasive and unnecessary treatments,” says ACSH's Dr. Elizabeth Whelan. “I was already writing about this problem — that PSA tests are not infallible — nearly 15 years ago, warning about the avoidable havoc they can wreak on men’s lives,” she adds.