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Decrease in PSA Testing Leads to More Prostate Cancer Diagnoses at Later Stages


In a report recently published in the journal CA: A Cancer Journal for Clinicians, the American Cancer Society (ACS) said a decline in the use of PSA testing likely led to more men getting diagnosed with prostate cancer at later stages, with the highest incidence and mortality rates occurring among Black men.

History of PSA Testing

A PSA test is a blood test that looks for levels of a prostate-specific antigen, or PSA, which, when higher, can indicate prostate cancer and other conditions. When PSA testing was introduced, it resulted in a surge in detected prostate cancer cases in the early 1990s. However, because many of those cases were either very slow-growing or had no symptoms, some people in the medical community feared that some men would undergo unnecessary treatments that could cause harm. In 2008, a government-backed task force recommended against the test for older men, and in 2012, they recommended against it for all men, after which, not surprisingly, incidences of detection fell. Additional research has since been done and the same group recommended in 2018 that men between 55 & 69 should consult with their doctor about the test because risks in this age group did not necessarily outweigh the benefits.

Advanced Prostate Cancer Is More Difficult to Treat

Dr. Andrew Flum, a urologist at KCUC, encourages men to talk to their primary care physician and request regular prostate cancer screenings (every one to two years) starting at age 40-55 depending on individual risk factors. “I think the key points here are that despite the decrease in the death rate from cancer overall, there has been an increase in patients presenting with advanced prostate cancer which is more difficult to treat and more likely to lead to significant morbidity and possibly death,“ Dr. Flum said. “This increase in patients presenting with advanced prostate cancer is likely attributable to a decrease in regular prostate cancer screening driven by the USPSTF (U.S. Preventive Services Task Force) giving PSA screening a “D” rating and recommending against its routine use from 2012 to 2018.”

Regular Prostate Cancer Screenings Save Lives

To aid in early detection of prostate cancer, KCUC recommends regular prostate cancer screening in men starting at age 40-55, depending on personal risk factors, and continuing every 1-2 years until at least age 70-75 depending on individual overall health and life expectancy. Prostate cancer screening should consist of a PSA blood test and prostate exam. We recommend patients discuss prostate cancer screening with their primary care physician or establish care with a urologist to ensure they are screened appropriately.

American Cancer Society Revises Screening Recommendations

The ACS said it would invest in research on prostate cancer and programs to boost access to quality screening and treatment. The ACS is revising its screening guidance and said doctors could use PSA test results, combined with tools such as better MRI imaging and genetic information, to make more informed decisions. “We can no longer stand back and not act,” said Karen Knudsen, ACS’s chief executive officer.

The bottom line is your health is in your hands. Every person is different. Talk to your doctor about your risk factors and get tested as often as recommended. Prostate cancer is readily treatable if discovered early.

If you haven’t had a PSA test in the last two years, come see one of our board-certified urologists at one of the nearby 23 KCUC Urology and Oncology locations throughout Kansas and Missouri for a prostate cancer screening. At KCUC, you see the best in KC. Contact us or make an appointment online.