Why I decided to get a PSA screening test for prostate cancer

I’m a big believer in avoiding over-testing and over-treatment. So it might surprise you that I opted to undergo prostate-specific antigen (PSA) screening for prostate cancer right around the time that the US Preventive Services Task Force recommended against PSA screening in healthy men of any age.

I know that PSA is a very imperfect indicator. I definitely want to avoid the stress and possible discomfort of having a biopsy. I’m worried about false positive and false negative biopsy results. And I don’t relish the significant potential for incontinence, impotence, or bowel problems from treatment.

But at this stage of my life I am willing to accept a significant risk of morbidity in exchange for a small reduction in mortality risk, which is my impression of what my choice to have the PSA test means. In 10 or 20 years I probably won’t feel that way. And I hope there will be better detection, follow-up and treatment options by then.

I’m also confident in my ability to make informed choices with my physicians along the way. The PSA test itself was done as part of routine blood work and there was no additional risk from that. My doctor and I agreed that if the PSA is elevated we’ll discuss what to do next. At that stage I’ll also have the chance to do more research and get more opinions if necessary. I’m not automatically going to get into a cascade of follow-up and treatment.


May 24, 2012

3 thoughts on “Why I decided to get a PSA screening test for prostate cancer”

  1. You say you are not going to get into a cascade of follow-up and treatment. But you are already over the precipice. What wil you know then that you don’t know now. What if your PSA is a little bit elevated? Or a lot?

    How do you draw the line?

    I took that gamble last year, then had to proceed with a biopsy. After all, Why take the PSA. If…

    (it was negative)

    When I went to see the doc for a follow-up visit, his nurse wanted to take another PSA. When I refused she was totally stunned.

    Maybe in a year or two, I’ll do it again, I dom’t know why. By thn I’ll be in my seventies?

    Len – age 68

    btw: How old are you?

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