PSA Test No Longer Recommended For Men Over 40

The U.S. Preventive Services Task Force recently issued a recommendation that healthy men should no longer be screened for prostate cancer with the PSA test.  A PSA test measures the amount of prostate-specific antigen (PSA) in the blood.  High levels of PSA may, but not always indicate the presence of prostate cancer.

The recommendation comes from a review in the Annals of Internal Medicine which  found no difference in overall survival between men randomly assigned to get a PSA test and other men who did not get a PSA.

Up to 13% of men getting a PSA will have a “false positive,” in which the results signal a possible cancer when men are actually cancer free. These false alarms can lead to stress, as well as invasive needle biopsies. Over 10 years, up to 20% of men who get a PSA screening will have a biopsy. One-third of men who undergo biopsies experience pain, fever, bleeding, infection, problems urinating or other effects that the men consider a “moderate or major problem.”

Up to 60% of prostate cancers never need to be found, because they grow so slowly that men are likely to die of something else long before their prostate tumor becomes a threat.

Prostate cancer surgery increases a man’s risk of urinary incontinence by 28%, from 21% among men who didn’t have surgery to 49% among men who had surgery.

Prostate cancer surgery increases a man’s risk of erectile dysfunction by 36 percentage points, from 45% among men who haven’t had surgery to 81% among men who have had surgery.

Up to one in 200 men die from prostate cancer surgery.