Any potential benefits derived from screening asymptomatic men need to be weighed against the harms of screening and diagnostic procedures and treatments for prostate cancer.
Whatever the screening modality, the screening process itself can lead to psychological effects in men who have a prostate biopsy but do not have prostate cancer. One study of these men at 12 months after their negative biopsy who reported worrying that they may develop cancer (P < .001), showed large increases in prostate-cancer worry compared with men with a normal prostate-specific antigen (PSA) (26% vs. 6%). In the same study, biopsied men were more likely than those in the normal PSA group to have had at least one follow-up PSA test in the first year (73% vs. 42%; P < .001), more likely to have had another biopsy (15% vs. 1%; P < .001), and more likely to have visited a urologist (71% vs. 13%; P < .001).
Two tests are used to look for prostate cancer: a digital rectal exam and a PSA blood test.
The PSA blood test looks for something called prostate-specific antigen in the blood. Who should have a PSA test and when is controversial:
The U.S. Preventive Services Task Force does not recommend regular PSA tests. The task force say the tests may find cancers that are so slow growing that treatment, which can have serious side effects, would offer no benefit.
The American Cancer Society (ACS)...
Three cohort studies in Sweden and in the United States linked databases to examine the association between new diagnosis of prostate cancer with cardiovascular events/death or with suicide. One Swedish study found that in the first year after the diagnosis of prostate cancer, the risk of death from cardiovascular disease (CVD) was increased in men diagnosed with prostate cancer compared with men who were not diagnosed with prostate cancer (relative risk [RR] = 1.9; 95% confidence interval [CI], 1.9–2.0; adjusted for age, calendar time period, and time since diagnosis). The risk of death from CVD was highest in the first week after diagnosis (RR = 11.2; 95% CI, 10.4–12.1) and was also higher in younger men (age < 54 years). These risks were less in men diagnosed in the most recent time periods. Also in the first year after diagnosis, the risk of committing suicide was higher for men who had been diagnosed with prostate cancer (RR = 2.6; 95% CI, 2.1–3.0; adjusted for age, calendar time period, marital status, educational level, and history of psychiatric hospitalization). Again, this was highest in the first week after diagnosis (RR = 8.4; 95% CI, 1.9–22.7). A second Swedish study largely confirmed these findings.