Prostate specific antigen: A useful screening test?

The role of prostate specific antigen (PSA) as a screening test for prostat e cancer is controversial. Proponents of screening emphasize that early det ection can lead to discovery of organ-confined disease and the potential fo r cure. Opponents point to the lack of credible evidence that screening is associated with a decrease in mortality, In addition, population-based scre ening (with subsequent diagnosis and treatment in many men) can be associat ed with considerable morbidity and mortality in the context of a disease th at is often not fatal. This report examines the limitations of PSA as a scr eening test and supports an approach using "verbal informed consent" to ide ntify patients who should be rested.