Both Canada and the U.S. agree that prostate-specific antigen (PSA) screening tests have a greater risk of doing lasting harm than providing any potential benefit. The test often shows a false positive result which can cause unnecessary worry and in a few men, complications such as fever, infection, bleeding, urinary problems and pain.
According to the U.S. Preventive Services Task Force, in many cases prostate cancer is slow growing and a high PSA level can lead to mistreatment of non-harmful cancers and result in treatment including surgery, radiation, or hormone therapy. Such cancers, if left alone would not cause health problems. More importantly, these often unnecessary treatments can having lasting harmful effects such as erectile dysfunction, urinary incontinence, bowel control problems and as with any surgery, a small risk of death or other serious complications.
For more information about the risks for prostate cancer, talk with your health care professional and discuss whether screening is necessary. In addition to the PSA blood test, doctors can use a digital rectal exam to check the prostate for any unusual lumps.
Prostate cancer is the second most common cancer in American men, following skin cancer. Older men, especially those with a family history and African-American males have a greater risk of developing prostate cancer. Most prostate cancers have a good prognosis and there has been a significant drop in PSA testing following the 2012 task force recommendations.
For more information about prostate cancer screening, diagnosis and treatment, visit the Centers for Disease Control and Prevention at: http://www.cdc.gov/cancer/prostate/index.htm . To review the Canadian recommendations on prostate cancer screening published in the Canadian Medical Association Journal visit: http://www.cmaj.ca/content/186/16/1225 .
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