Prostate-specific antigen screening: friend or foe?

Abstract

Prostate cancer is the most frequently diagnosed cancer among men in the United States. The prostate-specific antigen (PSA) blood test is the most commonly utilized test to detect early prostate malignancy. Elevated PSA levels suggest to providers the possibility that their patients are at a higher statistical risk of harboring asymptomatic, organ-confined prostate cancer. Although PSA testing has become a primary screening method for prostate cancer in the United States, this test has come under scrutiny. PSA screening lacks a high level of specificity due to frequent false-positive results. Additionally, major health organizations differ in their screening recommendations for use of the PSA test. However, the medical community, and more importantly, patients, must understand the benefits and possible detriments of this screening test. Providers should approach each man individually when recommending a PSA test, noting that many risk factors must be considered in a screening protocol for prostate cancer.