What is the role for PSA screening?
PSA screening should be offered to individual patients after appropriate counselling. Current recommendations suggest that men over the age of 50, with at least 10 years life expectancy should undergo annual screening by measuring their serum PSA. For men at high risk of prostate cancer, for example those with a first degree relative with prostate cancer, the screening age should start at 40. Recently published results from a large European randomised controlled trial show that PSA screening has the following effects: • Greater number of cancers detected • Higher proportion of cancers of earlier stage, and lower grade • Lower prostate cancer related mortality Population-based PSA screening cannot yet be recommended, since concerns remain regarding over-diagnosis and over-treatment.
