User:Regutten/sandbox/prostatecancerscreening

When screening for prostate cancer, the PSA test may detect small cancers that would never become life-threatening, but once detected will lead to treatment. This situation, called overdiagnosis, puts men at risk for complications from unnecessary treatment such as surgery or radiation. Follow up procedures used to diagnose prostate cancer (prostate biopsy) may cause side effects, including bleeding and infection. Prostate cancer treatment may cause incontinence (inability to control urine flow) and erectile dysfunction (erections inadequate for intercourse). As a result, in 2012, the U.S. Preventative Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA) based screening for prostate cancer finding, "there is a very small potential benefit and significant potential harms" and concluding, "while everyone wants to help prevent deaths from prostate cancer, current methods of PSA screening and treatment of screen-detected cancer are not the answer."

More recently, Fenton's 2018 review (conducted for the USPSTF) focused on the two highest quality randomized control studies of the costs and benefits of PSA screening that have been conducted, and the findings illustrate the complex issues associated with cancer screening. Fenton reports that the screening of 1,000 men every four years for 13 years reduces mortality from prostate cancer by just one. More specifically, of those 1,000 men: 243 received an indication of cancer during PSA screening (most of whom then had a biopsy); of those, 3 had to be hospitalized for biopsy complications; 35 were diagnosed with prostate cancer (and thus the false alarm rate from the original PSA screening was >85%); of those 35, 3 avoided metastatic prostate cancer and 1 avoided death by prostate cancer while 9 developed impotence or urinary incontinence due to their treatment and 5 died due to prostate cancer despite being treated. In their 2018 recommendations, the USPSTF estimates that 20%-50% of men diagnosed with prostate cancer following a positive PSA screening have cancer that, even if not treated, would never grow, spread, or harm them

Most North American medical groups recommend individualized decisions about screening, taking into consideration the risks, benefits, and the patients' personal preferences.