PSA Testing
Prostate cancer is the most common noncutaneous cancer detected in American men and the second leading cause of cancer-related deaths. The incidence of prostate cancer increases with age. Where 30% of men aged
60-69 will have the disease; autopsy incidence increases to 67% in men age 80-89. A 50 year-old American man has a lifetime risk of 40% for latent cancer, 16% for developing clinically apparent cancer, and a 2.9 risk of death due to prostate cancer.
PSA testing increases the detection rate of prostate cancer. Approximately 2.5% of men older than 50 years of age will be found to have prostate cancer.
Two large, randomized trials question the benefit of screening men for prostate cancer. In the US Prostate Lung, Colorectal, and Ovarian (PLCO) Screening Trial, no mortality benefit was observed after combined screening with PSA testing and digital rectal examination during a follow-up of 13 years. Although screening resulted in a 12% increase in prostate cancer detection, the cancer-specific mortality rate was similar in the screening and control arms (3.7 and 3.4 deaths per 10,000 person-tears, respectively). Similarly in the European Randomized Study of Screening for Prostate Cancer (ERSPC) trial, the benefit of PSA screening was minimal with a 20% relative reduction in death rate at follow-up of 9 deaths per 10,000 men screened.
The United States Preventive Services Task recommendations may be accessed at http://www.ahrq.gov/clinic/pocketgd1011/gcp10s2.ht
These recommendations state:
1. There is insufficient evidence to recommend for or against screening
2. Screening is not recommended in men aged > 75.
Since incontinence of urine and impotence are potential side effects of the treatment, I personally do not recommend or receive prostate cancer screening.
I encourage you to do your own research and be assured I will follow your desire.