Context

Prostate-specific antigen (PSA) screening for prostate cancer may prevent some men dying from the disease.1 However, had they not been screened, many contemporary men diagnosed with prostate cancer would never have experienced symptoms or died from their cancer. Considering the devastating impact of an unnecessary cancer diagnosis and treatment-associated sequelae, PSA screening as it is currently used arguably results in greater harm than good. Nevertheless, PSA is entrenched in healthcare systems across the globe and, until we identify another test that can accurately discriminate the few potentially fatal malignancies from the many more indolent prostate cancers, PSA screening will likely remain commonplace. As such, strategies to improve the use of PSA screening are critically important to limit harms.