What rating does the USPSTF give the PSA antigen test for screening prostate cancer?

• A. 55-69: A; 70+: B
• B. 55-69: B; 70+: C
• C. 55-69: C; 70+: D
• D. 55-69: D; 70+: C

Answer: (C)

The rating reflects how the balance of benefits and harms of PSA-based screening changes with age. For people aged 55 to 69, the USPSTF assigns a C grade. This means that screening should not be routine for everyone in this age range, but it may be considered after a thorough discussion with a clinician about potential benefits (early cancer detection) and the substantial potential harms (false positives, unnecessary biopsies, overdiagnosis, and possible overtreatment). The decision should be guided by individual values and risk factors.

For those aged 70 and older, the USPSTF assigns a D grade, indicating that screening is not recommended. In this older group, competing health priorities, shorter remaining life expectancy, and the higher likelihood of harms from screening and subsequent interventions outweigh any potential benefit.

In short, PSA-based screening is considered potentially reasonable for some men 55–69 after shared decision-making, but not recommended for most men 70 and older.