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Should prostate-specific antigen screening be offered to asymptomatic men?
Heidi A van Vugt1, Chris H Bangma, Monique J Roobol
1Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands. h.a.vanvugt@erasmusmc.nl
Expert Review of Anticancer Therapy
|July 22, 2010
Summary
Population-based prostate cancer screening can detect early cancers but lacks an optimal strategy. Current PSA screening methods risk overdiagnosis and overtreatment, requiring informed patient decisions.
Area of Science:
- Urology
- Public Health
- Oncology
Background:
- Population-based prostate cancer screening aims to reduce mortality by detecting cancers early.
- Prostate-specific antigen (PSA)-based screening is debated due to insufficient optimal strategies and risks of overdiagnosis/overtreatment.
Purpose of the Study:
- To evaluate the current state of prostate cancer screening.
- To inform men about the benefits and harms of PSA screening for informed decision-making.
Main Methods:
- Review of existing prostate cancer screening guidelines and evidence.
- Analysis of the benefits and harms associated with PSA screening.
Main Results:
- Early detection of prostate cancer can reduce mortality.
- Optimal screening strategies remain undefined, leading to diverse international guidelines.
- Overdiagnosis and overtreatment of indolent cancers are significant concerns.
Conclusions:
- PSA-based screening is currently insufficient for public health policy due to knowledge gaps.
- Informed decision-making is crucial, highlighting the need for patient and physician awareness of screening side effects.
- Premature algorithms recommending early screening, short intervals, or low PSA thresholds lack evidence.
