The United States Preventive Services Task Force (USPSTF) has recommended against getting routine Prostate Specific Antigen (PSA) testing. They believe regular PSA testing can cause significant harm to a person. Are they right?
The prostate gland has epithelial cells which produce this protein for semen in men. There is also a small amount of PSA in the blood too. However, a high level of PSA in the blood could be a sign of prostate cancer. A healthy man without prostate cancer would usually have a PSA level of under four ng/mL in their blood. But if a man develops prostate cancer, the PSA level in their blood will increase to over four ng/ML.
In about 15% of cases, men with less than four ng/ML of PSA may still develop prostate cancer. The only way to find out for sure is if a biopsy is performed. Unfortunately, most men don’t even bother getting any prostate cancer screening tests unless they experience actual symptoms, such as urinary incontinence.
Overall, PSA tests are better for detecting early signs of prostate cancer. A lot of men with high PSA levels could have an enlarged prostate rather than prostate cancer. Just because you have an elevated PSA level, it doesn’t automatically mean you have cancer.
So, why did the USPSTF make such a controversial recommendation about advising against getting a PSA test? Perhaps it is due to the adverse effects of PSA screening that got detected, such as increased anxiety, the negative side effects of prostate biopsies, and overdiagnoses of cancer.
There are low-risk prostate cancers that don’t require treatment. And yet, PSA screening encourages the overuse of therapeutic treatment that could cause a patient more harm than good. On the other hand, it is not an opinion everyone shares in the medical community or in leadership positions.
Here is one prominent example:
President Barack Obama
The USPSTF’s stance against PSA screening didn’t seem to deter President Barack Obama from getting screened himself in 2011. Dr. Jeffrey C. Kuhlman, who was the White House physician, released a report back on October 31st, 2011, that showed President Obama requested a PSA test as part of his annual physical.
The PSA test is not a normal part of a president’s annual physical. However, President Obama felt it was essential to personally request the test because he was approaching 50 years of age. That is the age when someone is more likely to develop prostate cancer, so he thought it was important to check for it.
Fortunately, the test did not show that President Obama had any prostate cancer. The PSA test did not cause any harm to him either. Since the President has some of the best doctors in the world caring for him, would they really let him take a PSA test if they thought it was dangerous? Of course not.
If President Obama was brave enough to get the test for himself, other men should do the same. You don’t need to have a team of White House doctors to stand by your side either. A layperson with a simple health insurance policy could request a PSA test from a licensed urologist.
The critics will say President Obama was fine after taking the PSA test because he has the best doctors to monitor his health carefully. But all those doctors do is assist him if he develops a health complication. The PSA test never caused him any health complications, so the critical argument falls flat.
The Test is Worth It
PSA testing is cheap and affordable for the average person. It may not be a perfect test, but it can tell you a lot about your prostate health. In the end, it should be the patient’s choice and not anyone else’s choice. Just make sure you consult with a primary care physician and urologist before proceeding. They can answer all your questions and give you the confidence needed to get the test done.