Prostate specific antigen Useful screening tool or potential liability?

Background The uncertainty regarding prostate specific antigen (PSA) screening for prostate cancer has not been alleviated, despite recent randomised controlled trials and position statements released by authoritative bodies. Objective This article summarises authoritative position statements by representative bodies in Australia and describes legal considerations for a general practitioner when deciding whether to order PSA tests as a screening tool for prostate cancer. Discussion Prostate specific antigen as a primary screening tool is generally not endorsed by most authoritative bodies in Australia, with the exception in some circumstances for men 55-69 years of age. Where asymptomatic patients request a PSA be undertaken, a GP can be justified both to order a PSA test or not to, such is the context of peer professional opinion provisions in Australian legislation and conflicting authoritative position statements regarding PSA. Where there is still ongoing uncertainty, the matter may be appropriately referred for specialist consideration.