“We Must do Better,” A Position Statement Regarding PSA Screening from Dean Foster, MD, PCRI Medical Director

Last May, the U.S. Preventative Services Task Force (USPSTF) triggered a firestorm of debate after issuing its recommendation against the use of the prostate-specific antigen (PSA) blood test to screen for prostate cancer. In her editorial responding to the controversy, Task Force Chair, Dr. Virginia Moyer summarized the committee’s findings with this sentence, “We can do better.” The Prostate Cancer Research Institute (PCRI), while disagreeing with the Task Force’s simplistic banning of PSA, does agree with Dr. Moyer’s conclusion: We can indeed do better.

“We can do better in educating men on the pros and cons of PSA,” explains Dr. Dean Foster, the PCRI medical director and prostate cancer survivor. “However, all the recent controversy is giving men an excuse to tune out about a disease that affects one in six of them. The subject of prostate cancer already makes men uncomfortable.  The controversy over the PSA test gives them one more reason not to pay attention.”

The PCRI encourages men to learn about PSA testing in consultation with their physician. When PSA screening is implemented and elevated levels are detected, further education is necessary before undergoing biopsy. For men with a high PSA, the PCRI currently recommends two additional tests prior to undergoing biopsy: PCA--3, a widely available urine test, and multi-parametric MRI. The PCRI offers free Helpline services to aid men in locating centers offering these services. 

Finally, Dr. Foster concludes: “Men can receive the benefit of PSA screening and still protect themselves from the risk of overtreatment, which is the main factor cited by the U.S. Preventative Services Task Force for giving PSA a “D” rating. The PCRI stands in agreement with Dr. Moyer and the USPSTF in that ‘we all must do better.’  However, PCRI does not recommend simply abandoning PSA screening. Through education, unnecessary overtreatment of the benign type of prostate cancer can be avoided while still using PSA to detect the aggressive form.”