Course Description

Prostate cancer is the second most common form of cancer among men, following only skin cancer. Early detection significantly increases the likelihood of long-term survival. However, the widely used prostate-specific antigen test (PSA), a blood serum test used to detect prostate cancer, is the subject of much debate. Although the incidence of prostate cancer has decreased in recent years, it is unclear how much of this effect can be attributed to PSA screening. Experts disagree on the need for the test, in addition to its effectiveness. Elevated PSA levels may indicate changes in the prostate unrelated to malignancy, producing patient anxiety and prompting physicians to prescribe treatment for conditions that might never be life-threatening. Professional societies, such as the American Cancer Society and the American Urologic Association, have developed different guidelines regarding the role of PSA assessment in cancer screening. Refinements to the PSA test have been made over the past 2 decades, but more research is needed to develop a tumor marker that would better identify aggressive cancers.

Learning Objectives

After reading this article, participants should be able to:

• Understand how the prostate-specific antigen (PSA) test works in identifying patients with prostate cancer.
• Discuss the debate over the effectiveness of the PSA test in identifying tumors that must be aggressively treated from tumors that require monitoring of progress.
• Explain new screening methods and the need for a better marker.