Despite the fact that screening for many cancers is associated with net harm, healthcare consumers continue to be screened. PSA is the most commonly performed laboratory screening test for cancer in men, but is associated with harms including complications such as erectile dysfunction, urinary incontinence and bowel dysfunction that may result from prostatectomy or radiation therapy after being diagnosed. In addition, various psychosocial morbidities may result from positive or false-positive results, and a cascade of follow-up tests and treatments. Appropriate use of laboratory screening tests has been documented to improve health outcomes.
This presentation will describe/list:
• Major epidemiological biases that positively impact perception of screening effectiveness including lead-time and length biases
• Current recommendations in the United States for PSA screening for prostate cancer
• Criteria adopted by the World Health Organization (WHO) for effectiveness of any health screening program and how well the PSA test meets each.
These relate to:
o Societal burden of the disease
o Clinical performance of the screening test
o Acceptability and feasibility
o Ability for disease intervention
o Informed consent
o Better population health outcome with screening
The presentation will also note the consequences from screening and the dilemmas with laboratory-based screening tests such as PSA, while providing some recommendations for future use of these tests. The discussions are aimed at raising awareness about various issues surrounding prostate cancer screening using the PSA test to promote better use of laboratory screening services.