PSA screening for prostate cancer
Lowers prostate cancer deaths long-term, with real overdiagnosis.
What studies found
After 23 years in the 162,236-man ERSPC trial, screening cut prostate cancer deaths by 13%: one death prevented per 456 men invited. The balance of benefit to harm improved with longer follow-up.
The catch
Many cancers found would never have caused harm, and only about a quarter of raised PSAs proved to be cancer on biopsy. Benefit faded after screening stopped.
What to do
Discuss a baseline PSA at 45–50, earlier with a family history or if you are Black. See the prostate pathway.
Sources
Rung 4 of 5, Strong: At least one large randomized trial, or very large consistent studies, on this exact question. How we score
Step by step
For the whole picture, from prevention and screening to treatment and life after, see the prostate cancer page.
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