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Some experts argue that the PSA (prostate-specific antigen) test is not that reliable because it can give false positive (indicating cancer that is not there) and false negative (missing prostate cancer that is there) results. In fact, roughly 80 percent of the 1.6 million men who undergo prostatic biopsy in the United States each year because of an elevated PSA level have negative results on their biopsy, according to Dr. Robert Getzenberg, MD, director of research at the Brady Urological Institute at Johns Hopkins. So, is PSA overrated?
Now, we are happy for those men who discover they do not have prostate cancer, but this is a very high number of men who are subjected to an invasive procedure that turns out to be unnecessary. What is needed is a test that is more accurate and does not produce such a high number of false positives.
There’s also the issue of the false negatives. Some cases of prostate cancer, especially those that grow rapidly, may not produce much PSA. This can result in a test result that incorrectly indicates that you don’t have prostate cancer when you do.
Overall, the downsides of PSA testing can be boiled down to the following:
Concern about false-positive results that are caused by elevated PSA levels from something other than prostate cancer
Having to undergo invasive, stressful, expensive or time-consuming follow-up tests
Getting a false-negative result, leading to a missed diagnosis of aggressive prostate cancer that needs treatment
Experiencing anxiety or stress caused by knowing you have a slow-growing cancer that doesn’t need treatment
Having surgery, radiation, or other treatments that cause side effects that are more harmful than leaving the cancer untreated
As you can see, the simple act of getting a PSA test can result in many different scenarios. It’s important that you have a doctor who has lots of experience in interpreting PSA results along with any other information gathered from you and other tests in order that a proper and informative diagnosis is made.