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Editorial
Health Care Reform
September 28, 2009

Shared Decision Making for Prostate Cancer ScreeningDo Patients or Clinicians Have a Choice?

Arch Intern Med. 2009;169(17):1557-1559. doi:10.1001/archinternmed.2009.291

The prostate-specific antigen (PSA) test was introduced in the late 1980s. Twenty years later there remains inadequate evidence about its benefits and harms when used for screening. The seriousness of the disease is unquestioned—prostate cancer claimed an estimated 28 660 lives in 20081—and the human toll impels the public, clinicians, and the public health community to act. However, evidence that early detection improves outcomes is scant, the often latent forms of the disease may pose little clinical threat to patients, false-positive results are common, and the harms and downstream consequences may outweigh the benefits.

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