There are strong contra opinions, which I share. Blowing off low cost PSA tests done at the same lab visit where cholesterol is checked is folly. Do we want to go back to the pre PSA test 70s as stated in the very article when most cancers were detected AFTER they metasticized? Longer potential male lifetimes mean more opportunity for metasticized prostate cancers to eat away at your bones. Get checked. And if and only if the doctor decides there's a PSA anomaly, then get a biopsy done. That test has a very high degree of cancer detection and minimal false positives. They also analyze your 12 site sampled cells under a microscope to determine via the Gleason scale the specific type and aggressiveness of the cancer. You want it dealt with before it bursts out of the prostate into the lymph nodes and pelvic bones. Your longevity outlook is radically different pre breakout vs post breakout.
What follows is meant to be educational, not an "attack."
There are two ways to measure the "effectiveness" of a diagnostic test such as PSA screenings:
Sensitivity: How often does the test pick up a condition when it's present? [In math terms, it's (true positives)/(true positives + false negatives).]
Specificity: How often does the test say that a condition is not present when it is, in fact, not present? [In math terms, it's (true negatives)/(true negatives + false positives).]
High sensitivity is good, since you don't want to miss disease; high specificity is also good, because it means you're not doing additional tests on people who are healthy.
The problem with the PSA is that it's not extraordinarily sensitive—a significant number of men with prostate tumors have
normal PSAs—and it's not extraordinarily specific—a significant number of men who don't have prostate cancer have
elevated PSAs.
No test is 100% specific and 100% sensitive. A big part of the problem with diagnostic tests is that it's almost always a trade-off: to make the test more sensitive, you almost always are going to have more false positives; to make the test more specific almost always means more false negatives.
So the debate comes down to whether the test does more good for the true positives than it does harm to the false positives and false negatives.