It may seem counterintuitive and controversial, but the official advice from the United States Preventative Services Task Force and some other medical associations is that men don’t need routine testing for prostate-specific antigen (PSA), a protein associated with prostate cancer. Fewer than one in three men with a high PSA result actually have prostate cancer, found only after getting an invasive biopsy (which can cause ED and incontinence). Even in men who have prostate cancer, a recent large study showed that men who monitored their cancer with their doctor had the same low rate of death as men who got treatment right away.
“In many cases you can actually do more harm with treatment than if you did nothing at all,” says Michael Munger, president-elect of the American Academy of Family Physicians. He doesn’t routinely screen his patients with the PSA test, but he will order it if a man comes in with symptoms like bloody urine. When he sees patients with no symptoms who want the PSA test, after he explains the risks of treatment for little to no benefit, he says they tend to react with, “Why would I want to do that?”