Pathology consultation on prostate-specific antigen testing.

OBJECTIVES: To provide clarity on the pros and cons of using prostate-specific antigen (PSA) as a screening tool for prostate cancer. METHODS: Case scenarios and a literature review of recently published clinical trial data are presented to provide evidence of the controversy. RESULTS: PSA is a sensitive biomarker for detecting diseases of the prostate, but it is limited in its ability to distinguish cancerous from noncancerous conditions or aggressive from indolent cancers and has resulted in a considerable amount of overdiagnosis and overtreatment. CONCLUSIONS: The analytical methodology for total PSA testing is both reliable and cost-effective, but patients should be encouraged to talk to their providers to understand the benefits and harms associated with this testing.