Editing CUA: Prostate Cancer Screening (2017) (section)

== PSA Screening ==

* '''CUA suggests offering PSA screening to men with a life expectancy > 10 years.''' The decision of whether or not to pursue PSA screening should be based on shared-decision making after discussing the potential benefits and harms of screening
** Up to 67% of men diagnosed with PC by screening will have clinically insignificant PC. Thus, if screened, men with insignificant disease may be unnecessarily exposed to the potential harms of both prostate biopsy and treatment in addition to the psychological effects. Increased use of active surveillance for low-risk PC has been important step in reducing the over-treatment of PC.
* There have been 6 randomized controlled trials investigated the role of PSA screening in adult men, however, 3 of these are at significant risk of bias and are not considered when weighting the evidence for or against prostate cancer screening. Thus, '''3 randomized controlled trials constitute the credible Level 1 evidence concerning PC screening: PLCO, ERSPC, Gotteberg (since publication of trial, results of CAP published) (see Prostate Cancer Screening Chapter Notes)'''
** '''Overall, PSA screening results in reduction in PC mortality.'''