Prostate-specific antigen screening: a critical review of current research and guidelines

Abstract

Purpose: Screening for prostate cancer (adenocarcinoma of the prostate), using the prostate-specific antigen (PSA) test is controversial among health professionals and organizations who publish screening guideline recommendations for healthcare professionals. Controversy stems from conflicting research studies regarding the efficacy of PSA screening with regard to improved survival rates. This article serves as a critical review of the current guidelines and research to determine which screening practices may be most beneficial to utilize with patients.

Data sources: Literature review of evidence for and against using the PSA test as a screening tool published from 2007 to 2012.

Conclusions: Some earlier evidence is currently used to support the guideline recommendations published by professional organizations that recommend against routine screening of asymptomatic men. However, the majority of the latest research demonstrates consistent results showing a reduction in mortality associated with PSA screening.

Implications for practice: Initiating screening at age 40, to obtain a baseline value, is recommended for primary care providers and is supported by the most recent evidence.

Keywords: Cancer; guideline development; male; screening.