By
Dr. Zachary Klinghoffer, Urologist, Rouge Valley Health System Early detection of prostate cancer using the prostate-specific antigen (PSA) blood test has remained a controversial topic for several years. The PSA test is often used as a tool to help detect prostate cancer before men develop symptoms, and before the disease has a chance to spread beyond the prostate.
Most groups agree that the decision to screen for prostate
cancer with the PSA test should be the result of a detailed discussion between
a man, his physician, and any others who may help the decision-making process,
such as a spouse, family member or friend. Various decision aid tools are
available to help with this process.
The test cannot provide a definite answer as to whether or not
a man has prostate cancer. In general,
the higher the number on the PSA test, the higher the chances of having
prostate cancer. However, many men with high numbers do not have prostate
cancer (this is called a false positive test), while others with low numbers actually
do have prostate cancer (this is called a false negative test).
Several large studies released within the past five years
have suggested that using the PSA test to screen for prostate cancer can reduce
the number of men who die from this disease. However, these benefits do not
come without risks. These same studies suggest that, in order to save one man’s
life, a very large number would have to be screened.
Furthermore, some men would be diagnosed with, and
potentially treated for, less harmful forms of prostate cancer that may never
have had any effect on their lifespans. Numerous medical associations in the
U.S. and Canada, such as the U.S. Preventative Services Task Force and the
Canadian Urological Association, have taken the results of these studies and
interpreted them in different ways.
While some take a “men should
be screened” or a “men should not be
screened” approach, most recognize that the issue is far too complicated to be
reduced to a simple “yes” or “no” answer.
As long as a man has been provided with the appropriate
information and resources he needs to make a well-informed decision, as well as
the time and opportunity to ask questions of his physician, the choice he makes
about PSA screening will always be the right one.
