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“What should happen before asymptomatic men decide whether or not to have a PSA test?” A report on three community juries

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Prostate-specific antigen (PSA) testing of asymptomatic men remains controversial.1 Testing may improve prostate cancer survival rates,2 but can also lead to harms, such as repeated investigations and the unwanted effects of treatments, including incontinence and impotence.35 Evidence regarding benefits and harms alone has not resolved tensions over PSA testing.6 Disagreement among experts and in guidelines has confused public communication in Australia and internationally.7,8

In December 2014, the Prostate Cancer Foundation of Australia (PCFA) and the Cancer Council Australia (CCA) released clinical consensus guidelines for general practitioners for public comment,9 after the National Health and Medical Research Council (NHMRC) had published information on the topic for health practitioners.10 These documents established criteria for identifying men more likely to benefit than to be harmed by PSA testing. However, it remains unclear if and when GPs should introduce the subject of PSA testing in consultations with individual men. The Royal Australian College of General Practitioners (RACGP) advises GPs not…