re: #33 webevintage

Routine PSA testing is controversial. Recent data suggests it may do more harm than good. From the NCI website:

“Using the PSA test to screen men for prostate cancer is controversial because it is not yet known for certain whether this test actually saves lives. Moreover, it is not clear that the benefits of PSA screening outweigh the risks of follow-up diagnostic tests and cancer treatments. For example, the PSA test may detect small cancers that would never become life threatening. This situation, called overdiagnosis, puts men at risk of complications from unnecessary treatment.

“The procedure used to diagnose prostate cancer (prostate biopsy) may cause harmful side effects, including bleeding and infection. Prostate cancer treatments, such as surgery and radiation therapy, may cause incontinence (inability to control urine flow), erectile dysfunction (erections inadequate for intercourse), and other complications. For these reasons, it is important that the benefits and risks of diagnostic procedures and treatment be taken into account when considering whether to undertake prostate cancer screening.”

i.e. yes, the test picks up cancers, especially very early and small ones. But there is no good evidence that picking them up early actually changes long term outcomes, and there is evidence that treatment can cause a lot of harm (impotence, incontinence) in men who wouldn’t have died from the disease if untreated.