Is PSA testing useless?
No, but the problem is that it is not good for medically defined screening in that a raised PSA level is just a general warning signal, not something specific to a dangerous prostate cancer. Diagnosing prostate cancer is more complicated than only measuring PSA, and needs additional checks like imaging the prostate and extracting cells for analysis. Deciding when and how to treat is more complicated again – needless surgery can cost lives or inflict disability for no benefit, but waiting too long can also be a mistake. PSA use needs to be part of good personal care, not mass screening.
The key message about PSA testing is that it should be conversation between a man and his health care provider and, ultimately, should be an informed decision, taking into account the man's individual risk factors and weighing the benefits against any possible limitations. Right now, the PSA test is the only test available for prostate cancer. Men should get a PSA test in their 40s to establish their baseline. Men at high risk for prostate cancer should talk to their primary care provider before age 40 about prostate cancer. At or over age 70, the decision to end prostate cancer testing should be based on an informed discussion with their primary care provider. When detected early, the survival rate of prostate cancer can be over 90%. For more information please visit: www.prostatecancer.ca/PSA