PSA & Prostate – Why it’s not a Screening Test

Based on BMJ 2013;346;f325

GPs have received expert guidance, from the UK and the US, that they can ‘improve the health of their patients by advising them AGAINST having the PSA test’ as a screening tool for prostate cancer in those without prostate symptoms. This is because, based on research involving hundreds of thousands of people over many years, we now know that:

  • The test is unlikely to prevent you dying from prostate cancer over the next 10 or 15 years or help you to live longer
  • Elevated PSA levels are common and lead to additional tests which can be harmful
  • PSA testing finds cancers which may never cause problems. But once these cancers are found it is hard not to treat it. These treatments can result in significant side effects such as impotence and urinary incontinence
  • By choosing not to have a PSA test you can have a similar length of life and avoid the potential harms associated with tests, procedures and treatments
  • For every 1,000 men who are screened with a PSA test
    • 1 death from prostate cancer will be prevented
    • 100 will receive a false positive and will need prostate biopsy
    • 100 will be diagnosed with prostate cancer and most likely receive potentially harmful treatment, which they may never have needed
  • Biopsies and treatment are associated with significant harms

This UK view agrees with US Screening Recommendations 2012 which does NOT recommend screening for prostate cancer at any age as the benefits of screening for prostate cancer by measuring PSA does not outweigh harms.

Some High Risk men may still prefer to have the test. Please see the below leaflet:

If you have Prostate Symptoms

If you have prostate symptoms you can check and score them on this International Prostate Symptom Score tool (IPSS) and bring the result with you to an appointment with a GP at the practice to discuss and assess futher:

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