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EBM opinion and debate
Controversies in PSA screening
  1. Jack O’Sullivan
  1. Correspondence to Dr Jack O’Sullivan, Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK; jack.osullivan{at}phc.ox.ac.uk

https://doi.org/10.1136/ebmed-2017-110858

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    Forty years after its discovery, a reanalysis of the two largest trials to date, controversially suggests that prostate-specific antigen (PSA) screening may actually be beneficial.

    Most healthcare organisations do not recommend PSA screening for prostate cancer,1 2 mainly in response to conflicting evidence about the benefits and clear evidence of harms. PSA can lead to false positive or ‘overdiagnosed’ cancer (detecting prostate cells that histologically represent cancer, but will never grow to cause a patient harm).

    Evidence regarding efficacy has been based on two large randomised controlled trials: The European Randomised Study of Screening for Prostate Cancer (ERSPC)3 and Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO).4 These trials are both considered to be of high quality, but the trials came to …

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    Footnotes

    • Twitter @JackOSullivan3.

    • Contributors JOS conceived the ideas and wrote the article. It is entirely his work.

    • Funding My DPhil (PhD) is funded by the Clarendon Fund, University of Oxford.

    • Competing interests I receive income from Oxford University Hospitals for clinical work and hold grants from the National Institute for Health Research and the Primary Care Research Trust. My views are entirely mine and do not represent any of my employers.

    • Provenance and peer review Commissioned; internally peer reviewed.