New Research Shows Benefits of PSA Screening
January 06, 2023
An estimated one in nine men are diagnosed with prostate cancer in their lifetime, making prostate cancer the most common cancer in men. However, because it tends to grow slowly, prostate cancer is also one of the most treatable cancers. When detected and treated early, the survival rate for prostate cancer is very high.
Cancer screening detects cancer before symptoms appear – when the disease is usually easiest to treat. In the case of prostate cancer, prostate-specific antigen (PSA) testing has been the primary screening method used since the 1980s. PSA is a protein made in the prostate gland. High or rising levels of PSA in the blood may indicate the presence of prostate cancer.
However, in the past decade, the use of routine PSA screening has dropped off because of controversy surrounding its benefits and risks.
What’s the PSA Controversy?
About 80% of men who reach age 80 have cancer cells in their prostate gland. However, in most cases, the disease does not lead to death or even noticeable symptoms.
PSA testing cannot tell the difference between slow-growing cancers that do not pose any significant dangers and less common, potentially life-threatening cancers. This fact coupled with incomplete and misleading data about the outcomes of prostate cancer led some professional groups to question the value of PSA screening, claiming its risks could outweigh its benefits.
The risks of the PSA screening include subjecting men with harmless prostate cancers to unnecessary biopsies (invasive removal and analysis of tissue samples) and unneeded treatments that can cause impotence, incontinence, bowel problems and other side effects. As a result of these concerns, some disease prevention organizations issued guidelines recommending that most men not get PSA screening.
What the Latest Research Says
“Current national prostate cancer screening recommendations do not accurately reflect the benefits of PSA screening,” says Jonathan Shoag, MD, a urologist at University Hospitals and Assistant Professor of Urology at Case Western Reserve University School of Medicine. “As a result of these recommendations, we’re seeing many men diagnosed with more aggressive, advanced-stage prostate cancer because they weren’t screened earlier.”
Dr. Shoag is a senior author of a study published in May 2022 that found strong evidence that PSA screening is more valuable than previously thought in the prevention of advanced-stage prostate cancer and prostate cancer deaths.
“To assess the benefits of a cancer screening,” says Dr. Shoag, “we often look at the number of people needed to be diagnosed or treated to prevent one death from that cancer. This study found those numbers to be far more favorable towards PSA screening than previous estimates, particularly with regard to screening black men.”
Earlier studies suggested that PSA screening only prevented one death for every 23 men diagnosed with prostate cancer. The new study found that PSA screening prevented one death for every 11-14 men diagnosed with the disease. Among black men, who are at higher risk of dying from prostate cancer than men in general, the benefits of PSA screening were even greater.
PSA Screening Saves and Improves Lives
Dr. Shoag says, “We have a proven test that can save men’s lives by finding prostate cancer early. These latest findings show convincingly that otherwise healthy men in their late 40s and early 50s should get a baseline PSA screening.”
He also notes that prevention of death isn’t the only benefit of PSA screening, because advanced prostate cancer that does not lead to death can still negatively affect a man’s quality of life by causing pain and other unwanted side effects.
Dr. Shoag hopes this latest study will get more doctors advocating the use of PSA screening and that the current screening guidelines get updated.
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At University Hospitals Seidman Cancer Center, our care team offers the most advanced forms of cancer care, including prevention, screening, diagnosis, treatment and cancer survival support. Our disease-focused teams design personalized cancer treatment plans for every patient who entrusts their care to us. Learn more about cancer care at UH Seidman Cancer Center. Questions? Call the University Hospitals Cancer Information Service Line at 855-892-8110.
If you have symptoms that suggest prostate disease or have been diagnosed with prostate cancer, call 216-844-3951 today to schedule an appointment with a men’s health expert. We offer both initial consults and second opinion appointments.