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"The net mortality benefit is small, and this needs to be weighed against the increased chances of being diagnosed and treated for prostate cancer," she said. "Before undergoing PSA screening, men should be aware of the possible benefits and harms, and of their chances of these benefits and harms occurring."

Dr. Michael Pignone, an assistant professor of cancer prevention and control at the University of North Carolina at Chapel Hill and author of an accompanying journal editorial, said that "when you total up the potentially beneficial and potential detrimental consequences of PSA screening, it is not clear that the net effect of PSA screening is beneficial."

Pignone noted that the consequences of prostate cancer treatment, such as impotence and incontinence, occur with treatment. "You suffer the down sides right away," he said. "You only get the benefits, in most cases, far into the future."

Pignone noted that even men with prostate cancer are more likely to die from heart disease or dementia than their cancer. Your chance of dying from prostate cancer is one in a 1,000, while the odds of dying from another cause is 113 in 1,000, he said.

Brawley noted that the American Cancer Society is reviewing its recommendations for PSA screening, and is expected to change them next year.

"Men should know that there are huge question marks, and for some men who are very concerned, perhaps they should get screened. For some men who are less concerned about prostate cancer, perhaps they should not get screened," Brawley said. "But men should not be told that prostate cancer screening is more beneficial than we have evidence to show."

More information

For more information on prostate cancer, visit the American Cancer Society.

SOURCES: Richard M. Hoffman, M.D., M
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