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PSA Standardization

Arguments Against Screening for Prostate Cancer

Slide 8

October 2009

The arguments against prostate cancer screening focus on the high rate of detection of indolent cancers with PSA and the overtreatment of tumors unlikely to cause mortality.  There is a great amount of lead time bias such that it gives an illusion of improved survival.

Furthermore, because PSA does not have high specificity, a large number of prostate biopsies are performed to completely rule out cancer and there is morbidity associated with the cancer treatment, and less often, with the biopsies themselves.  As noted in the recent clinical trials there is no conclusive evidence that screening improves patient outcomes.

Finally, there is significant cost associated with the downstream effect of an elevated PSA, including biopsies, repeat testing, and increased patient anxiety, all of which place further burden on the economic and healthcare system.  While there are strong arguments for and against screening, at present it is apparent that for now PSA will continue to be utilized.

Against Screening


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