Serum prostate-specific antigen (PSA) testing arrived on the scene more than 20 years ago, offering great promise for the early detection and treatment of prostate cancer. Yet even after 2 decades of experience with this seemingly simple blood test, debate continues to swirl over how and when—and if—it should be used.
Prostate cancer appears in a large percentage of men as they age, but is indolent most of the time. Critics emphasize that PSA testing is an imperfect screening tool because it does not differentiate clinically significant tumors from ones that would never cause harm, and the result is overdiagnosis and overtreatment. Others defend the use of PSA testing and say that a more rational, evidence-based approach to using it can help detect and treat prostate cancer early in men who would die of the disease.
Friedrich MJ. Debate Continues on Use of PSA Testing for Early Detection of Prostate Cancer. JAMA. 2011;305(22):2273-2276. doi:10.1001/jama.2011.777