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Evidence to Improve Care

Prostate-Specific Antigen–Based Population Screening for Prostate Cancer

Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee recommends against the introduction of a formal, population-based prostate-specific antigen (PSA) screening program for prostate cancer in Ontario.

Read the full OHTAC Recommendation

Prostate cancer is the most common cancer among men in Canada. This cancer forms in the prostate, a part of the male reproductive system that adds nutrients and fluid to sperm. Advanced prostate cancer can be fatal or decrease a man’s quality of life. However, most prostate cancers grow slowly, and even without treatment many men with slow-growing prostate cancer will die of some other cause.

Health Quality Ontario Reviews Prostate-Specific Antigen Screening for Prostate Cancer

The prostate-specific antigen (PSA) blood test is widely used in Canada to diagnose and monitor patients with prostate cancer. It tests for a protein produced in the prostate. Higher levels of this protein may indicate prostate cancer, but may also be a result of other prostate conditions. Patients then need further testing to understand the reason for their high PSA levels and, if cancer is present, whether it is a slow-growing or advanced cancer.

There has been debate about whether to introduce a formal program to screen all men over a certain age for prostate cancer. There is concern that such a program would detect many slow-growing, low-risk cancers and could lead to unnecessary treatment and health care costs, as well as anxiety for the patient.

Prostate-Specific Antigen (PSA)-Based Population Screening for Prostate Cancer: An Evidence-Based Analysis(PDF)
May 2015

Prostate-Specific Antigen (PSA)-Based Population Screening for Prostate Cancer: An Economic Analysis (PDF)
May 2015

Harms of Prostate-Specific Antigen (PSA) Screening in Prostate Cancer: A Rapid Review (PDF)
May 2015

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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry has no current plans to fund the PSA test for population-based screening purposes.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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