No More PSA Tests!

PSA tests no longer recommended for most men according to American Urological Association

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) PSA tests are no longer recommended for men as screens for prostate cancer. Those are the new guidelines released today by the American Urological Association (AUA).

The new recommendations apply to men between the ages of 55 and 69. PSA (prostate-specific antigen) screenings are not recommended for any other age group. 

The AUA now says that patients in that age group should talk with their doctors about the benefits and harms of the testing.

Men can then decide whether or not to have the test based on their personal values and preferences.

These guidelines do not apply to men who have symptoms of prostate cancer or whose family cancer histories put them at higher risk of the disease.

"Discuss cancer screening options with an oncologist."

The new clinical guidelines were released at the 2013 AUA Annual Meeting in San Diego, CA.

These recommendations are updates for the Association’s 2009 Best Practice Statement on Prostate-Specific Antigen (PSA).

"The new guideline is significantly different than previous guidance inasmuch as it was developed using evidence from a systematic literature review rather than consensus opinion; provides rating and interpretation of the evidence based on randomized controlled trials with modeled and population data as supporting evidence; and develops statements that do not go beyond the available evidence," the AUA said in a press release.

The Prostate Conditions Education Council (PCEC), a national organization committed to men’s health and a leader in prostate cancer early detection, released the following statement in response to new clinical practice guideline released today by the American Urological Association (AUA). 

“PCEC applauds the American Urological Association for its diligent work on their new prostate cancer clinical practice guidelines announced today and its recognition that as medicine continues to evolve so must the protocols for the disease. We look forward to continuing the discussion around the best practices for the diagnosis and treatment of prostate cancer,” said PCEC Chairman E. David Crawford, MD in a press release.

Current evidence shows that if men between the ages of 55 and 69 are screened with PSA tests at two- to four-year intervals, one man per 1,000 screened will avert a prostate cancer death over a decade.

Here is a summary of the new guidelines:

  • PSA screening is not recommended in men under age 40 years.  
  • Routine PSA screening is not recommended for men aged 40 to 54 who have average prostate cancer risk.
  • Men between the ages of 55 and 69 should discuss PSA screening with their doctors and proceed based on the man's own judgment.
  • Men over the age of 70 and those whose life expectancies do not extend beyond 10 to 15 years should not be screened.
  • To reduce the chances of false-positives (suspicious area turning out to be nothing), a two-year screening interval versus annual screening is recommended for men who decide to have the testing.

"It’s time to reflect on how we screen men for prostate cancer and take a more selective approach in order to maximize benefit and minimize harms. The best available evidence suggests that following these guidelines will lead to an improved benefit-to-harm ratio,” said H. Ballentine Carter, MD, who chaired the panel that developed the guideline.

“Our hope is that men will understand that knowledge is power and that by knowing more about their prostate health, they will be able to make better and more informed choices about screening and, if necessary, the diagnosis and treatment of prostate conditions,” said PCEC member Nelson Stone, MD.

Reviewed by: 
Review Date: 
May 3, 2013
Last Updated:
November 4, 2013