Prostate Cancer – Pros & Cons of PSA Testing
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What is prostate cancer screening?
A prostate cancer screening is a test that your healthcare provider uses to look for prostate cancer before you have any symptoms. The 2 types of prostate cancer screening tests are the digital rectal exam (DRE) and the prostate-specific antigen (PSA) test.
Should I be screened for prostate cancer?
The Canadian Task Force on Preventative Health Care (CTFPHC) recommend against routine PSA-based screening for prostate cancer.
Based on evidence from research studies, prostate cancer screening — and especially the PSA test — may cause more harm than good for most men. Learn more about the PSA test and the pros and cons of this test below.
What is the PSA test?
The PSA test is a blood test that measures the level of prostate-specific antigen (PSA) in your bloodstream. PSA is a substance produced by the prostate gland. A small amount of PSA usually is found in the blood. But because cancer cells produce more PSA than normal cells, men who have prostate cancer may have a higher level of PSA in their blood. A PSA level can also be high because of less serious causes, such as infection or prostate enlargement.
What are the pros of PSA testing?
The main goal of the PSA test is to find prostate cancer early. For people who have fast-growing (aggressive) tumors, early detection could be very helpful (if the cancer has not spread outside of the prostate at the time it is detected). Cancer is usually easier to treat and is more likely to be cured if it is caught early. However, most men who have prostate
cancer do not have the fast-growing, aggressive form of prostate cancer that might benefit from being found early.
What are the cons of prostate cancer screening?
Most men who have prostate cancer have a slow-growing form of cancer. This means that they probably do not have symptoms and may not ever need treatment. However, 90% of men who learn that they have cancer through screening go on to receive treatment anyway. Many experience long-term side effects of treatment, such as urinary incontinence and erectile dysfunction, or have serious complications.
In addition, PSA test results aren’t always accurate. This means that the PSA test result suggests that you might have cancer when in fact you do not. A false positive test result can lead to unnecessary tests (such as a biopsy) and side effects from testing, and may cause worry for you and your family.
For these reasons, some medical organizations, including the The Canadian Task Force on Preventative Health Care (CTFPHC), recommend against routine PSA testing for men of all ages.
How do I make a decision?
Ultimately, the choice is yours. If you’re thinking about being screened for prostate cancer, contact your healthcare provider. Consider the pros and cons of screening, your health and individual risk factors, your preferences regarding diagnosis and treatment, and your healthcare provider’s opinion and advice.
Where can I learn more about prostate cancer screening?
Healthcare providers and researchers are performing research studies (called clinical trials) to learn more about the risks and benefits of prostate cancer screening. Ask your healthcare provider about the most recent study results.
FOR MORE INFORMATION
Canadian Cancer Society
Prostate Cancer Canada
National Guideline Clearinghouse, Agency for Healthcare Research and Quality. Screening for Prostate Cancer. Accessed August 21, 2012
U.S. Preventive Services Task Force. Screening for Prostate Cancer. Accessed August 21, 2012