Which statement best reflects USPSTF's position on PSA-based prostate cancer screening?

• A. Routinely recommended for all men
• B. Not routinely recommended for all; shared decision making is recommended for certain age groups
• C. Not recommended for any age
• D. Required for all men at age 50

Answer: (B)

PSA-based screening is not recommended for all men; the USPSTF supports an individualized approach with shared decision making for certain age groups. This reflects the balance of benefits and harms: PSA screening can modestly reduce prostate cancer mortality, but it also leads to false positives, unnecessary biopsies, overdiagnosis, and treatment side effects like incontinence and erectile dysfunction. Because these trade-offs vary with age and overall health, the guideline endorses discussing potential benefits and harms with patients—particularly those in the 55 to 69 age range—rather than applying a universal screening rule. For men outside that age range (notably those 70 and older), routine screening is not recommended due to a smaller or unlikely net benefit.