Abstract
Prostate cancer represents the most common noncutaneous cancer in men in the United States. Although PSA testing with or without digital exam has led to increased prostate cancer detection, it continues to lack specificity, which leads to the inability to predict which men will benefit from biopsy and/or prostate cancer treatment. The lack of specificity has led to varying screening recommendation from multiple organizations. Patients are also questioning the benefit of PSA screening. This article reviews the history of prostate cancer and PSA screening, discusses the current controversy in PSA screening, and provides guidelines for the role the advanced practitioner in patient selection and counseling. The continual controversy has led to more interest in pursuing more accurate predictors of prostate cancer. A discussion of emerging biomarkers, PCA3, and the TMPRSS2:ERG gene is also included.
