The Value of PSA Screening

Neha Vapiwala, MD
Last Modified: March 5, 2007

Question:

Dear OncoLink "Ask the Experts,"
In the "Ask the Experts" article entitled Prognosis After Prostatectomy, a woman asked whether her family physician had erred by not routinely screening her husband for the past 10 years with a PSA.

The answer given was that he should have had annual PSA testing in conjunction with a digital rectal exam starting at age 50-55. There was no mention of the controversy surrounding this approach in the medical community or the lack of hard data to support this approach (though some data is now emerging). Please elaborate on this.
JD

Answer:

References

Burack RC, Wood DP Jr. Screening for Prostate cancer: the challenge of promoting informed decision making in the absence of definitive evidence of effectiveness. Medical Clinics of North America 83: 1423-42, 1999.

Catalona WJ, Hudson MA, Scardino PR, et al: Selection of optimal prostate specific antigen cutoffs for early detection of prostate cancer: Receiver operating characteristic curves. J Urol 152:2037-42, 1994.

Mettlin C, Jones G, Averette H, et al.: Defining and updating the American Cancer Society guidelines for the cancer-related checkup: Prostate and endometrial cancers. CA Cancer J Clin 43:42-46, 1993.

Mettlin C, Murphy GP, Babaian RJ, et al: The results of a five-year early prostate cancer detection intervention. Investigators for the American Cancer Society National Prostate Cancer Detection Project. Cancer 77:150-9, 1996.

Montie JE, Wood DP Jr, Pontes JE et al: Adenocarcinoma of the prostate in cystoprostatectomy specimens removed for bladder cancer. Cancer 63:381-5, 1989.

Sakr WA, Grignon DJ, Crissman JD, et al: High grade prostatic intraepithelial neoplasia and prostatic adenocarcinoma between the ages of 20-69: An autopsy study of 249 cases. In Vivo 8:439-43, 1994.

Smith DS, Humphrey PA, Catalona WJ: The early detection of prostate carcinoma with prostate specific antigen: The Washington University experience. Cancer 80:1852-6, 1997.

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