Dr. Oliver Sartor on Considerations, Controversy With PSA Testing in Prostate Cancer

A. Oliver Sartor, MD, Medical Director of Tulane Cancer Center, explains why primary care physicians and oncologists/urologists have differences of opinion when it comes to prostate-specific antigen (PSA) testing.

Internists will point out that PSA testing has many false positives and explaining the pros and cons of the test to patients is too time consuming, says Sartor. However, oncologists think about PSA everyday, he says.

Randomized trial data from Sweden showed a clear benefit to PSA testing in younger men, says Sartor. The PLCO trial, which many use to argue against PSA, was extremely contaminated as many patients in the control arm received PSA, and therefore should not be considered, explained Sartor.

PSA has the ability to save lives, says Sartor, but active surveillance must be used wisely for patients with low-risk disease.