Sharing the Decision Slide Set: Slide 31

Talking Points and Text Description of Slide

Slide 31 — Summary

Talking Points

We have attempted to show a balance between the potential benefits and harms or side effects of screening and early treatment.

On the benefits side, evidence appears strong that PSA screening leads to early detection of prostate cancer. There is evidence that treating PSA-detected prostate cancer may be effective in reducing the likelihood that patients will die from the disease, but other evidence makes this uncertain. PSA use may contribute to the decline in U.S. prostate cancer mortality, but the evidence is not consistent.

For harms or side effects, false positives are common. Overdiagnosis is a problem, but we are uncertain about the magnitude. Treatment-related side effects are fairly common.

The balance of potential benefits and possible side effects is uncertain. This uncertainty leads the clinician to ask the next question.

Text Description of Slide

Summary of potential benefits and harms:

Potential Benefits

• PSA screening detects cancers earlier.
• Treating PSA-detected cancers may be effective, but we are uncertain.
• PSA may contribute to the declining death rate, but we are uncertain.

Potential Harms

• False positives are common.
• Overdiagnosis is a problem, but we are uncertain about the magnitude.
• Treatment-related side effects are fairly common.

Bottom line: Uncertainty about benefits and magnitude of harms.