Can a PSA test do any harm?
It’s a simple blood test that’s entirely safe. But an abnormal test usually leads to a prostate biopsy. Although biopsies are frightening and uncomfortable, serious side effects are uncommon. But if a biopsy reveals cancer, it usually leads to treatments that often produce impotence, sometimes cause urinary incontinence, and may have other physical and psychological side effects. Most men would gladly trade potency and even continence for life, but it’s not that simple. If treatment saves lives, the PSA test has done much more good than harm, but if men would live as long with no treatment or late treatment, the simple blood test will have done more harm than good. It’s intuitively obvious that early cancer treatment can save lives, but since the average prostate cancer grows slowly, it’s not necessarily so. Table 3 summarizes the estimated impact of untreated prostate cancer on life expectancy; it suggests that low-grade cancers do little harm, even in young men, and that moderately l
