According to the US Preventive Services Task Force, which advises the government on health prevention measures, PSA test used for the screening of prostate cancer is no longer recommended. The panel has downgraded the screening test to level “D”, i.e. the service does not offer any benefits and on the contrary, it may prove harmful. The panel has downgraded the test after reviewing increasing scientific evidence against the test. The committee found that compared to the number of prostate cancer deaths it prevents, PSA or prostate specific antigen test, results in over-treating a condition which might not produce any harm if left untouched. The side effects of prostate cancer treatment are often more damaging than the disease itself.
A rise in PSA levels is not restricted to prostate cancer alone. It is raised in case of infections, benign prostate hypertrophy and even after recent ejaculation. But since the test is always associated with prostate cancer, an elevated PSA levels can produce unnecessary anxiety. A diagnosis of prostate cancer can double the risk of dying due to a heart attack or committing suicide, as per the findings of a study by researchers of Harvard and Brigham & Women's Hospital in Boston. Similarly, side effects of surgery and radiotherapy for prostate cancer can result in incontinence and impotence. Quite often than not, prostate cancer is a very slow growing tumor found in elderly people and the potential harm caused by its treatment far outweighs the benefits. Also, there is a high incidence of false positive tests owing to the widespread use of PSA tests. Keeping these points in mind, the committee has recommended that PSA test for prostate screening is no longer required.
However, many physicians disagree with the latest recommendations. One in every 6 men in America is diagnosed with prostate cancer and it is the second leading cause of cancer related death in the US. PSA screening, despite its shortcomings, has been instrumental in a 30% decrease in the death rate due to prostate cancer. Therefore, the recommendations by the US panel have met with widespread criticism. These recommendations have not yet been included in the treatment guidelines for prostate cancer.