The history behind this is that 30+ years ago, oncologists didn't have as many secondary diagnostic tools, so they'd overtreat any suspect PSA just to be safe.

Now they have a crazy-rich range of tools, from better biopsies to vastly-improved imaging to germline and epigenetic gene tests, so they can get a lot of confirmation that a slightly-elevated PSA actually *means* something before charging in with a scalpel or radiation. They can literally look inside your body and even peek into your DNA.

And even if treatment is necessary, both surgery and radiation have advanced significantly and have many fewer side-effects than they did in the 1990s.

People (doctors or otherwise) who argue against routine PSA screening still have their heads stuck in the era of fax machines, Nirvana, The X Files, Netscape Navigator, and the Clinton presidency.

Fortunately, prostate cancer diagnosis and treatment have progressed a long way since then, which is why I'm still alive to write this rant. 🙂