Should Baseline PSA Testing Be Performed in Men Aged 40 to Detect Those Aged 50 Or Less Who Are at Risk of Aggressive Prostate Cancer?(Original Articles) (Clinical Report‪)‬

Although prostate specific antigen (PSA) screening of asymptomatic men aged 50-75 years may reduce the prostate cancer mortality by at least 20%, there is concern about the high rate of overtreatment. (1) The risk of overtreatment is increased in older men with less aggressive cancer. In men younger than 50 years--especially those with high-risk prostate cancer--early diagnosis and curative treatment are more important than in elderly men, and the risk of overtreatment is less. Before the advent of widespread PSA testing, men 50 years old comprised 0.8-1.1% of patients diagnosed with adenocarcinoma of the prostate in the USA. (2) With the widespread use of PSA testing and public awareness of prostate cancer, this figure in the USA is currently 3.7-4%. (3)