Screening for Prostate Cancer -- The Controversy That Refuses to Die

doi:10.1056/NEJMe0901166

Published at www.nejm.org March 18, 2009 (10.1056/NEJMe0901166)

Screening for Prostate Cancer — The Controversy That Refuses to Die

Michael J. Barry, M.D.

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Editor's note: Do the benefits of PSA screening outweigh therisks? Watch video of a roundtable discussion, participate ina poll, and contribute your comments in our Clinical Directionsfeature — Screening for Prostate Cancer. Commenting closesApril 1, 2009.

In the United States, most men over the age of 50 years havehad a prostate-specific antigen (PSA) test,¹ despite the absenceof evidence from large, randomized trials of a net benefit.Moreover, about 95% of male urologists and 78% of primary carephysicians who are 50 years of age or older report that theyhave had a PSA test themselves,² a finding that suggests theyare practicing what they preach. And indeed, U.S. death ratesfrom prostate cancer have fallen about 4% per year since 1992,five years after the introduction of PSA testing.³ Perhaps theanswer to the . . . [Full Text of this Article]

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From Massachusetts General Hospital and Harvard Medical School, Boston.

This article (10.1056/NEJMe0901166) was published at NEJM.org on March 18, 2009. It will appear in the March 26 issue of the Journal.

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