In May 2018, the USPSTF upgraded the recommendation to a “C,” denoting men between the ages of 55 to 69 at average risk of developing prostate cancer should discuss the benefits and harms of screening with their doctor, so they can make the best choice for themselves based on their values and individual circumstances. Screening for cancer is generally thought to be a good thing, but once the risks outweigh the benefits, the test may actually be doing more harm than good.ĭue to concerns about overdiagnosis and overtreatment, in 2012, the United States Preventive Services Task Force (USPSTF) discouraged PSA screening in healthy men of all ages, a “D” recommendation.Įvery man who has a life expectancy estimated to be greater than 10 years should at least have the conversation with their physician about the pros and cons of checking their PSA levels. Men with harmless cancers may then be subjected to unnecessary biopsy, as well as unnecessary treatments that may cause side effects such as impotence, incontinence, or bowel dysfunction. Shortcomings of PSAĪlthough the early detection and diagnosis of aggressive prostate cancer is critical to improving survival, PSA cannot reliably tell the difference between slow-growing cancers that do not pose a risk and less common, potentially deadly cancers. Since that time, the United States has seen more than a 50 percent drop in deaths from prostate cancer in the United States. Thus began the “modern era” of prostate cancer, when tumors are more frequently diagnosed while still contained within the prostate and, therefore, more likely to be curable. who were free of signs and symptoms of the disease started regularly getting their PSA levels checked.Īs a result, prostate cancer began to be diagnosed far more frequently, both in men who, if not treated aggressively, could die from the disease and men who had prostate cancers that were never destined to cause symptoms or problems. Millions of men over the age of 50 in the U.S. In the late 1980s and early 1990s, the prostate specific antigen (PSA) test, which measures a protein produced by both normal and cancerous cells in the prostate, emerged as a simple blood test to indicate the likelihood of having prostate cancer. Up until the late 1980s, men were typically diagnosed at a late stage, when they presented with bone pain and symptoms of the cancer’s spread, known as metastases. Prostate cancer is the most commonly diagnosed cancer among American men and remains the second-leading cause of cancer-related death.
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