Serum prostate-specific antigen screening for prostate cancer: application of current evidence to model criteria

Prostatic carcinoma, particularly in younger men, carries a significant possibility of morbidity and mortality, although authoritative diagnosis and treatment itself is not without associated risks. Controversy still looms with respect to the actual implementation of routine serum prostate-specific antigen (PSA) screening for the general public. A brief summary of indications for screening programmes is presented, and these concepts are applied specifically to the body of research surrounding prostate cancer screening with PSA testing. Due to the slowly-progressive natural history of prostate cancer and the high morbidity associated with confirmation biopsy and definitive treatment, periodic general screening with insensitive and nonspecific PSA secrum testing emerges as an inefficient allocation of health care capital. The possible effectiveness of targeted screening practices for selected high-risk individuals, however, is considered.