PSA screening — a review of recent studies

Abstract

In spite of the absence of level one evidence for its effectiveness, the use of screening has been prevalent worldwide with rates of around 70% in the US and 20– 40% in European countries. Prostate specific antigen (PSA) and digital rectal examination (DRE) are the most commonly applied screening tests. PSA was introduced into clinical medicine in 1987 and evidence for potential effectiveness in the early detection of prostate cancer emerged in the early 1990s after PSA driven biopsy indications revealed a significant down staging of prostate cancer at the time of diagnosis [ 1 Catalona WJ Smith DS Ratliff TL et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991; 324: 1156-1161 Crossref PubMed Scopus (1840) Google Scholar ]. In the meantime, level one evidence for an effectiveness of prostate cancer screening in terms of lowering prostate cancer specific mortality has emerged [ 2 Schröder FH Hugosson J Roobol MJ et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009; 360: 1320-1328 Crossref PubMed Scopus (3135) Google Scholar ]. The findings of this study will be presented and discussed and put into perspective with other emerging evidence of the effects of prostate cancer screening on a population based and individual basis.