Casey, in your reply to Phenom, you labeled his thinking to be of the 1990's variety and said that "more screening and less overtreatment" are inconguous.
To that, I say, "only if we allow that to be the case."
How is it more difficult to encourage wise decisions regarding cancer found during screening than it is to move physicians into the mindset of less intervention and wider use of active surveillance? It seems quite logical to want to be aware of a cancer in the body, whether in the prostate or elsewhere, and then determine what, if any, medical intervention is warranted.
It seems quite illogical to me to avoid the test which might show that cancer, with the goal being to avoid "overtreatment."
As several have pointed out in this thread, most of us rely on our physicians to tell us, during our annual physical exam, what tests we should have at this particular stage in our lives: occult blood, blood profile, colonoscopy, glucose tolerance, and yes, PSA. Truly, what percentage of men, without prompting from their doctor, will ask that these tests be ordered? And yet all of these tests can have life-altering consequences and side effects. It drives me a bit crazy that we keep trying to act as if the PSA test belongs in a different category from the rest. It's just a test, and it can be informative. It's painless.
I need to quit posting in these threads. Everyone has pretty well stated their personal beliefs, and that's good. What I don't like is being told by medical authorities that I'm not smart enough to make wise decisions regarding prostate cancer, so they have elected to protect me from all that by simply doing less testing. If I'm still around ten years from now, I wonder if I'll be reading about an epidemic of advanced cases of prostate cancer presenting at doctor's offices, all cropping up in men who, thank the Lord, were not "overtreated."