Guidance and recommendations for prostate cancer screening have changed over the years. While there is no standard screening test, doctors may use a prostate-specific antigen (PSA) test to help diagnose prostate cancer. Doctors may follow a positive PSA test with a prostate biopsy.
Most recommending bodies emphasize a shared decision-making (SDM) approach for prostate cancer screening by PSA testing. This strategy moves away from doctors making treatment decisions and instead relies on collaborative interactions between patients and healthcare teams.
Why do expert opinions on prostate cancer screening differ? This remains a complex question with a lot to unpack. First, we have limited treatment options for cancer that has already spread outside of the prostate. Thus, detecting these cases will often not improve health or prolong life. Second, many cases of slow-growing prostate cancer will never become life-threatening; detection of these cases can be considered overdiagnosis and may lead to anxiety, unnecessary treatment, and accompanying side effects. Unnecessary biopsies, which provide no additional value to patients and physicians in decision-making, can also come with complications such as bleeding and infection.
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