Español
Dominica
Providers Newsletter
The latest on a long‑standing controversy: the PSA test for prostate cancer.
June 12, 2026
Estimated Reading Time: 4m
Getty Images
A new analysis by Cochrane assessed the effects of prostate cancer blood screening tests, compared with not performing them, in men without a prior diagnosis of this cancer.
The work was based on the analysis of six randomized clinical trials conducted with a total of 789,086 randomly assigned participants. The trials were conducted in Europe and North America, and included men between the ages of 45 and 80.
According to their findings, screening tests known as PSA (prostate‑specific antigen, a protein produced by the prostate gland) could reduce overall mortality. Assuming a baseline risk of 491 deaths from any cause per 1,000 men, this corresponds to 5 fewer deaths per 1,000 men.
These screening tests likely reduce prostate cancer‑specific mortality and could reduce overall mortality, the analysis concludes. It adds that they could have little or no effect on adverse events, measured as intervention‑related mortality.
Prostate cancer is the second most prevalent cancer and the fifth leading cause of cancer‑related death in men worldwide. Nevertheless, the availability of studies on mortality trends in the Latin American and Caribbean region is limited.
In the region, approximately 226,000 cases are diagnosed annually, with about 61,000 deaths during that period.
Countries with a high burden of this disease, such as Brazil and Argentina, register rates of between 40 and 60 cases per 100,000 men.
In Guatemala, there was an increase in diagnoses in men between 30 and 59 years old, as well as in those ≥60 years old. Projections for 2030 suggest a further increase in prostate cancer mortality, attributable to changes in the structure and size of the region's population.
Despite the decrease in prostate cancer mortality rates recorded in the last two decades, countries in the region continue to have some of the highest mortality rates worldwide, particularly Venezuela in South America, and Trinidad and Tobago and Cuba in the Caribbean.
In Mexico, there are 19.4 deaths per 100,000 men.
Although it varies depending on the country, in most cases men usually come to the medical consultation when the prostate cancer is already in an advanced stage.
A blood test with more pros than cons?
These are some of the main conclusions of the Cochrane analysis, some of which leave open the debate about the need for further research:
- Screening for prostate cancer using a blood test to detect the level of PSA in the bloodstream probably reduces the risk of dying from prostate cancer and might also reduce the risk of dying from any cause.
- The tests probably make little or no difference in the diagnosis of advanced prostate cancer, but they could reduce the diagnosis of metastatic cancer, that is, cancer that has spread to other parts of the body.
- The tests likely increase the number of men diagnosed with any type of prostate cancer and with cancer at early stages, exposing some men to the risk of being diagnosed and treated for cancers that might not cause problems during their lifetime.
- A more recent approach that combines standard blood testing with a broader set of blood markers and prostate imaging probably detects more cases of prostate cancer, but it is still unclear whether it reduces deaths from this cancer or from any cause.
What is prostate cancer screening?
Prostate cancer develops in the prostate, a small gland located below the bladder that produces fluid for semen. It is one of the most common types of cancer in men and mainly affects those over 50 years of age.
If detected early, it can usually be treated successfully. Screening tests aim to diagnose it precisely at those stages, when there are still no symptoms or before the slow‑growing cancer causes problems.
The PSA blood test looks for elevated levels of this prostate protein in the blood, which can indicate prostate cancer. The next step for men with elevated PSA is a biopsy, in which a small tissue sample is removed for analysis.
Treatments such as surgery or radiation are then administered. However, these treatments can cause unwanted effects, such as loss of urinary ability, frequent need to urinate, difficulty achieving erections, and bowel problems.