Harvard Health Letter

Should you get a PSA test?

The latest thinking on this controversial screening.

If you're wondering whether to have your PSA tested, you're not alone. Some experts think you should have the test, but others disagree. In May 2012, the United States Preventive Services Task Force (USPSTF) issued its final report concerning screening for prostate cancer using the prostate-specific antigen (PSA) test. After weighing the best evidence, the expert panel concluded that PSA screening for prostate cancer should not be offered routinely to all men.

When used as a screening tool, the PSA test aims to check seemingly healthy men for hidden cancer at an early stage, when (hypothetically) it may be more curable. To date, the most positive research findings have shown that screening with PSA, at best, prevents about one death from cancer for every 1,000 men who have the test. This means many men are diagnosed and treated for cancers that would not have made them sick or shortened their lives. For such men, the treatment—which can produce side effects—is worse than the disease.

Although PSA screening has been thought to offer most potential benefit to men at elevated risk, such as African American men and men with a family history of prostate cancer, this has not been shown in studies conducted to date. "Before making any final choice about PSA tests, men first need to understand what is involved before and after they receive the results—whether it's good news or bad, and the difficult decisions you will face," says Dr. Marc Garnick, an expert on prostate cancer and a clinical professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center.

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