To make an informed decision about PSA screening, men need to have a balanced discussion about the pros and cons with their doctors or other health care providers. Only a minority of men have such a discussion.
This was seen in a study published online in the journal Urology in March 2017, which looked at a nationwide survey database of 217,000 men. Only 30 percent said that their health care providers discussed both the advantages and disadvantages of PSA screening with them. Meanwhile, 36 percent of men reported that only the advantages were discussed; 1 percent, only the disadvantages; and 34 percent reported that neither had been discussed. Men who discussed only the disadvantages or who had no discussion about screening were least likely to get the PSA test.
Previous studies have shown that when the pros and cons of PSA testing are fully discussed with men who have not yet made up their minds, they are more likely to decide against it, though this new study did not find that a balanced discussion dissuaded men.
Many doctors include the PSA test in routine blood work without asking, or even telling, their patients. Possible explanations include lack of time during office visits, disinclination to discuss a confusing topic, or doctors’ belief that the benefits of screening outweigh the harms.