Cancer ResearchWhy PSA Guidelines Are Failing Men and What Better Screening Looks Like
Peter Attia dedicates a solo episode to prostate cancer screening, arguing that outdated PSA guidelines have contributed to rising rates of advanced and metastatic disease. He explains that PSA is far more useful when tracked as a trend over time rather than as a single snapshot, and that modern tools — including MRI, PSA density, PSA velocity, and transperineal biopsy — can dramatically improve detection of aggressive cancers while reducing unnecessary procedures. He critiques the flawed PLCO trial evidence that drove guidelines away from routine PSA screening, discusses how finasteride and similar drugs can suppress PSA and mask warning signs, and makes a strong case for active surveillance as a way to avoid overtreatment in low-risk cases. The episode is a practical, evidence-based guide for men and their physicians navigating prostate cancer risk.
