Prostate-specific antigen screening, why have the guidelines changed?

Prostate cancer (PCa) constitutes a major health issue of the western world given its increasing rate of diagnosis and the fact that it is the second cause of cancer-related death among men. Although the incidence of PCa is rising, deaths from PCa are at the same time declining. This phenomenon has been largely attributed to the implementation of PCa screening. However PCa screening, which is mainly performed through serum prostate-specific antigen measurement, does not have the desired diagnostic accuracy. This results in a substantial proportion of men undergoing unnecessary biopsies and consequently given therapies for low-risk cancers that will have no effect in prolonging life and might as well only add morbidity. The current report will discuss the pros and cons of PCa screening in light of the recent modifications in the guidelines regarding the early diagnosis of PCa.