USPSTF Keeps PSA Screening Individual for Men 55-69 as Test Misses Specificity Despite 330,000 Cases
Updated
Updated · The Washington Post · Aug 31
USPSTF Keeps PSA Screening Individual for Men 55-69 as Test Misses Specificity Despite 330,000 Cases
3 articles · Updated · The Washington Post · Aug 31
Summary
Men 55 to 69 are still advised to make PSA screening an individual decision, while men 70 and older are advised against it, as clinicians move away from automatic biopsy after a high result.
PSA testing catches more than 90% of prostate cancers but has only 9% to 33% specificity, so many elevated results are false positives caused by benign enlargement, infection, inflammation or trauma.
In a study of more than 37,000 men, nearly 5,000 had elevated PSA results that led to biopsy, and more than two-thirds did not have prostate cancer; overdiagnosis is estimated in 20% to 50% of PSA-detected cancers.
Newer follow-up now often includes repeat PSA tests, blood or urine biomarkers, MRI and monitoring PSA velocity before biopsy, aiming to avoid unnecessary treatment and side effects such as incontinence or erectile dysfunction.
The shift reflects mixed evidence: PSA screening was linked to 13% lower prostate-cancer mortality in a 160,000-man European trial, but many low-grade cancers may never become harmful.