Issue Date: August 2, 2009
How important is a PSA test for men?
The prostate-specific antigen, or PSA, is a widely used part of screening for prostate cancer in men. Prostate cancer is very treatable if found early, but PSA testing is now being debated.
The age to start testing is now 40.
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One side says routine PSA testing is costly, and although it finds tumors, some people found to have cancer may not benefit from treatment. Many men develop prostate cancer as they age, but they die from other illnesses before the cancer causes problems. Those who argue against PSA testing say doctors may overdiagnose and, therefore, overtreat the cancer.
Advocates of routine PSA screening say prostate cancer is common, and survival depends on early detection. Testing has improved prostate cancer death rates, and treatment also has improved, so issues such as incontinence and sexual dysfunction aren't as problematic.
I like the American Urological Association's guidelines, updated this year. The group recommends that PSA testing should begin in men at age 40 instead of 50, and doctors also should use a physical exam of the prostate, changes in PSA readings over time and, when necessary, other specialized blood studies.
Tedd Mitchell, M.D., is president and CEO of Dallas' Cooper Clinic.
Want to know about prostate cancer treatment options?
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