PSA test results are interpreted as: 0-4 ng/mL is normal. Between 4 to 10 ng/ML is 25% of developing cancer, and > 10 ng/ml is a > 50% risk of cancer. However, some men with normal PSA levels still have prostate cancer, while other men with high PSA levels do not. PSA levels increase with age often due to a higher prevalence of benign prostate hypertrophy (BPH). Therefore, no PSA cutoff can accurately guarantee that a man does not have prostate cancer.
PSA blood levels are used for several different purposes such as to diagnose prostate cancer, evaluate treatment of prostate cancer, and to evaluate the severity of benign prostatic hyperplasia (BPH). Currently there is no way to determine between prostate cancers that is aggressive verse mild cases. When screening identifies cases that is not life threatening men may experience unnecessary worry and complication to include urinary incontinence, erectile dysfunction, and psychological problems.
One out of every five in 1000 men who are treated surgically will die within one month of the surgery. In addition between 10 and 70 of these men will have serious complications from surgery. Many others treated with radiotherapy or surgery 200-300 in 1000 will suffer long-term problems that include urinary incontinence, erectile dysfunction and bowel problems. The PSA screening test often produces false positive results, which leads to psychological effects and other adverse effects associated with biopsy such as infection, pain and bleeding as well as more unnecessary testing. (Chou et al., 2011). (Are all these statistics from chou?)
However, The American Urological Association along with the ACS believe that PSA-based screening and early treatment for prostate cancers are still essential for men but recommend they be applied selectively. The ACS supports patients making a shared decision with their practitioner after a thorough discussion of risk and benefits for men at high risk beginning at 50 years of age using PSA testing with or without DRE testing if their lifespan is greater than 10 years. The ACS guidelines also recommend screening men who are at high risk as early as 40 years of age (black, relative that was diagnosed young, Braca 1 (breast cancer) 1 or Braca 2. However, the USPSTF advises against PCa screening concluding there is moderate certainty that the benefits of such screening do not outweigh the harms (Quaseem et al., 2013).
In the case for PSA screening, PCa is the leading internal malignancy in US men and the second leading cause of cancer death in American men. Early detection of prostate cancers offers the best chance of cure. The PSA blood test is the best chance of cure. Currently, the PSA blood test is the best currently available way to detect PCa and it is easy, safe and inexpensive. PSA test results is a piece of information, it is what doctors do with the information that becomes the issue. However, the great majority of PSA detected tumors have the histologic...