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Nothing sparks more controversy in the urologic world as the PSA test. PSA is a blood test used in men to screen for prostate cancer. The higher the PSA, the greater the probability of finding prostate cancer on biopsy. The problem is that often we find small volume, less aggressive cancers that may not need to be treated. This can lead to overtreatment, which has potential negative effects. The data can be interpreted from different perspectives.
Some of the arguments against checking your PSA are:
Arguments in favor of checking PSA and screening for prostate cancer are:
Common sense needs to be used in this situation. Data and statistics can be manipulated to show almost anything you want. The short term U.S. study is roughly the equivalent of taking 1000 twenty-year-old men and having half of them smoke for five years. At the end of the study, the fact that no one had died of lung cancer or heart disease would then “show” us that tobacco doesn’t cause these problems. Does this mean it’s true? No, it means that the study was designed poorly.
PSA is a tool – it needs to be understood and not abused. Yes, PSA is overused and yes, prostate cancer is over-treated BUT these are problems we should learn from, not turn away from. Most urologists recommend screening every 1-2 years from ages 50 to 69. Men at higher risks or with symptoms can start earlier. Those who are in great health and have a life expectancy greater than 10 years can continue to check. This should be a shared decision between you and your doctor. I’m sure there is a lot more to come!
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