Prostate cancer screening guidelines and their alignment with recent literature

A prostate-specific antigen (PSA) test is a simple blood test that is used to screen for prostate cancer. Over the last 30 years, the benefit of screening with a PSA test has been a matter of significant debate because of its association with overscreening, overdiagnosis, and overtreatment of prostate cancer. Although most prostate cancer screening guidelines recommend a shared decision-making approach between the patient and provider, these recommendations are contradictory in terms of screening initiation, frequency, and discontinuation as well as screening recommendations for high-risk populations. This article describes a literature review comparing screening guidelines with newer research in order to determine which guideline aligns most closely with the latest findings. Results show that the related American Urological Association and National Comprehensive Cancer Network guidelines, for example, may lead to over- or underscreening, whereas the American Cancer Society (ACS) guideline seems most closely in alignment with recent research. By following the ACS guideline, most clinically significant prostate cancer should be captured with less risk of overscreening and overdiagnosis.