Harvard Men's Health Watch

Prostate-specific antigen: A new(ish) study

Prostate-specific antigen (PSA) is a protein produced by every prostate, benign or malignant. The prostate pumps the protein into the ejaculate, where it works to liquefy semen so sperm can swim to their intended target. Despite its importance, this reproductive function has been largely overlooked since 1987, when blood PSA levels were first used to screen for prostate cancer. By now, the majority of American men above age 50 have been tested at least once. Widespread acceptance notwithstanding, PSA screening for prostate cancer remains hugely controversial in scientific circles. A study from Gteborg, Sweden, presents a favorable view of screening but is unlikely to end the debate.

What we know

Prostate cancer is the leading internal malignancy in American men and the second leading cause of cancer death. Early detection offers the greatest likelihood of cure. PSA testing is the best currently available way to detect early prostate cancer, and the test itself is inexpensive, safe, and easy to obtain.

That makes PSA screening sound like a no-brainer, and it does make a strong and logical case for testing healthy men. But it doesn't tell the whole story. Doctors who question the value of routine testing have two basic concerns.

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