I'm a doctor of philosophy. As Dr. Ruth used to say, "I cannot advise" (although, oddly, giving advice was the entire reason for her existence). Anyhow . . .
The Brits tend to be considerably more clear-eyed than we are about the relative good and bad of doing medical type stuff, so leave it to BMJ to publish this meta-analysis from U.S. based researchers on prostate cancer screening. The money shot:
Screening was associated with an increased probability of receiving a diagnosis of prostate cancer (relative risk 1.46, 95% confidence interval 1.21 to 1.77; P less than 0.001) and stage I prostate cancer (1.95, 1.22 to 3.13; P=0.005). There was no significant effect of screening on death from prostate cancer (0.88, 0.71 to 1.09; P=0.25) or overall mortality (0.99, 0.97 to 1.01; P=0.44). All trials had one or more substantial methodological limitations. None provided data on the effects of screening on participants’ quality of life. Little information was provided about potential harms associated with screening.
Conclusions: The existing evidence from randomised controlled trials does not support the routine use of screening for prostate cancer with prostate specific antigen with or without digital rectal examination.
So here's what happens if decide to undergo prostate cancer screening:
1. The doctor may stick his finger up your ass. You may or may not like that.
2. You may be diagnosed with "prostate cancer."
3. You may spend time in a hospital, spending a lot of your own or other people's money, and undergo surgery or get yourself heavily irradiated "down there."
4. You may end up incontinent of urine, and unable to sustain an erection.
5. There is no reason to believe that you will live even a single day longer than you would had you not done all this.
So, make your own decision.
Note: As usual, if you have a family history, or if you are of African descent, or for whatever reason are at higher than usual risk, you may have a different calculation. You should talk with your doctor, but I warn you, they tend to be all for doing this, because that's just how they are. Also the urological, radiological and surgical societies won't like me for telling you this.
In the future, we hope, doctors will get better at distinguishing between dangerous and not so dangerous prostate tumors. When that day comes, all will be different.