Struggling with what to do as far as prostate cancer screening?
The Harding Center for Risk Literacy has some very helpful illustrative "Fact Boxes" that share the evidence behind Digital Rectal Exams (DREs) and Prostate Specific Antigen (PSA) tests.
Of course, these shared decision-making (SDM) aids only take into account the Cochrane Review, but this is a systematic meta-analysis and so I think quite powerful data.
To see a bit more background, but a similar conclusion, view this review in the Journal of Family Practice. They suggest:
Do not routinely screen all men over the age of 50 for prostate cancer with the prostate-specific antigen (PSA) test. Consider screening men younger than 75 with no cardiovascular or cancer risk factors—the only patient population for whom PSA testing appears to provide even a small benefit.
Family medicine literature seems to be consistent with the above, though our practice lags behind. Many of my urologist colleagues shake their head and insist that we offer screening PSAs, but I'm beginning to feel it just doesn't add up to "good care."
What do you think? Would you get screened? Would you encourage your patients to be screened?
If you are looking for more decision-making aids, check out the Hands On part of the Tools section on this site.