Prostate cancer screening with PSA

In an article by Ilic et al published in BMJ 2018, the authors present a meta-analysis of the evidence for prostate cancer screening with the PSA blood test. This evidence came from combining data from 5 studies (Quebec, Stockholm, ERSPC, PLCO and CAP). 721,717 men were included.

When considering the whole dataset, the authors found that screening in this way probably has no effect on death either from prostate cancer or from all causes. At best it may lead to a small reduction of death from prostate cancer after 10 years. This is balanced by harm, such that for every 1,000 patients screened 1,3 and 25 men have serious sepsis from the biopsy, need pads for incontinence and have erectile dysfunction respectively.