Experts Warn That Prostate Screening Practices May Not Benefit Those Most in Need

Recent research highlights concerns regarding current prostate-specific antigen (PSA) testing protocols, suggesting they may not effectively identify men who are most likely to benefit from screening. A comprehensive study involving over 10 million men in England, published by the British Medical Journal, reveals that PSA tests are increasingly performed more frequently than guidelines recommend, often in men without any symptoms or with low PSA levels. This trend raises risks of overdiagnosis and overtreatment, particularly in older men for whom repeated testing offers minimal benefit. Despite UK guidelines advising PSA testing primarily for symptomatic men or following active discussions with healthcare providers, the study shows that many individuals undergo unnecessary tests, contributing to increased healthcare costs and potential harm. The research also uncovers regional and demographic disparities, with higher testing rates among white populations and less deprived areas. Notably, nearly half of the men tested were retested, often without current symptoms or elevated PSA levels, and with intervals shorter than most clinical guidelines suggest. These findings underscore the urgent need for clearer, evidence-based guidelines to optimize PSA testing practices and minimize unnecessary interventions. Experts emphasize that unregulated testing could lead to substantial harms and costs, while potentially missing aggressive cancers that require prompt attention. The study advocates for more targeted screening strategies grounded in high-quality evidence to ensure maximum benefit and reduce the risks associated with overtesting.