Whether to screen for prostate cancer is an open question for clinicians and patients. Our latest Clinical Decisions presents the case vignette of a 55-year-old man who reports to the primary care clinic for a routine exam and asks whether or not he should have a PSA test. An argument to recommend prostate cancer screening is made by Dr. Anthony D’Amico from Brigham & Women’s Hospital and Dana Farber Cancer Institute. Dr. Matthew Smith from Massachusetts General Hospital Cancer Center makes an argument for NOT recommending prostate cancer screening. Both consider and evaluate the latest research, including a study published in this week’s NEJM that found PSA screening of men between the ages of 55 and 69 years resulted in a reduction in deaths from prostate cancer. However, when overdiagnosis and treatment sequelae were considered, the number of quality-adjusted life-years gained through screening was also reduced. (See also the accompanying editorial from Dr. Harold Sox.)
What would you recommend? Base your choice on the published literature, your own experience, recent guidelines, and other sources of information, as appropriate. Read the case vignette and the arguments, comment and cast your vote! The comments and poll are open until August 29, 2012.