PSA screening—a matter of debate?

Prostate cancer (PCa) is the most common cancer type in men. Overall, the goal of prostate-specific antigen (PSA)-based screening is to identify early-stage disease that can be treated successfully. However, evidence supporting an overall survival advantage in men undergoing PSA screening is controversial, leading to a lack of consensus on guidelines. The present review article provides an overview of the most important studies on PSA screening including the latest updates of large trials. In addition, modern concepts in early detection of PCa that can be added to PSA measurement alone such as PSA isoforms or mpMRI are discussed. Lastly, recommendations for PCa screening and early detection from the European and German Societies of Urology issued in 2019 are presented.