“To screen or not to screen. That is the question.” PSA Screening Powerpoint Presentation

Whether men should get tested for prostate cancer when they have no symptoms is a long‐running debate within the medical community.

There is good evidence, according to the Centers for Disease Control and Prevention (CDC), that the
current prostate specific antigen (PSA) test approved in 1986 by the Food and Drug Administration to
screen for prostate cancer can detect the disease in its early stages. Evidence, however, is mixed and
inconclusive about whether early detection actually saves lives.

At the same time, evidence, such as a drop in the prostate cancer death rate‐‐which some say could be
due to improved treatments‐‐suggests that early PSA testing may be saving lives. There are no
definitive answers.”

Scientists are studying the combination of PSA testing and digital rectal exam as a way to get more
accurate results from screening tests. Some cancers never cause symptoms or become life‐threatening,
but if found by a screening test, the cancer may be treated. It is not known if treatment of these
cancers would extend life longer than if no treatment were given, and treatments for cancer may have
serious side effects. Follow‐up tests, such as a biopsy, may also be done to diagnose cancer.

There are no controversies in clinical medicine, only levels of understanding and enlightenment.

Essential Points

  • If the purpose of the PSA test is to make a decision for radical prostatectomy, it is a poor test.
  • If the purpose of the PSA test is to make a decision for radiotherapy, it is a poor test.
  • If the purpose of the PSA test is to make a decision for chemotherapy, it is a poor test.

But

  • If the purpose of the PSA test is to assess prostate health, the PSA test is the most practical, cheapest, and useful test.
  • If the purpose of the PSA test is to assist us in separating men who require close monitoring for the presence of cancer, the PSA test, in most instances, is a useful test.
  • If the purpose of the PSA test is to monitor the efficacy of a cancer control program, it is more valuable than most types of scans for the prostate gland.