Prostate Blood Test: Life Saver or Unnecessary Risk?

A comprehensive review of six trials involving nearly 800,000 men indicates that prostate-specific antigen (PSA) blood tests can reduce prostate cancer deaths. The analysis, monitoring participants for extended durations, particularly the European randomized study of screening for prostate cancer (ERSPC) over 23 years, revealed that two deaths were prevented for every 1,000 men screened.

Despite the life-saving potential, experts caution that the absolute benefit is small and takes a long time to become apparent. The PSA test is known for its unreliability, detecting benign cancers that may never cause harm. This can lead to men undergoing treatments like radiotherapy and surgery, risking serious side effects such as incontinence and impotence.

Researchers emphasize that the findings do not support universal screening, highlighting the "very real risks" of overdiagnosis and unnecessary treatment. They advocate for shared decision-making between doctors and patients. While advancements like MRI-guided diagnostics and biomarker tests show promise, their effectiveness in saving more lives or reducing harm is still under evaluation. The UK National Screening Committee currently advises against widespread screening, recommending targeted programs for those with specific genetic mutations.