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Prostate cancer screening — MCCQE Part 1 MCQ

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ModeratePreventive MedicineProstate cancer screeningMCCQE Part 1

54-year-old man presents with asking for a PSA test. He is asymptomatic and has no family history. Which of the following is the most appropriate next step?

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Correct answer: D — Discuss uncertain benefits and harms before deciding about PSA testing

Discuss uncertain benefits and harms before deciding about PSA testing is best because Canadian guidance recommends informed discussion rather than routine population PSA screening. Use a United States screening schedule instead of Canadian guidance is suboptimal because MCCQE questions expect Canadian preventive-care guidance; Defer all preventive care until symptoms develop is suboptimal because screening and immunisation aim to prevent disease before symptoms; Order the most invasive test as routine first-line screening is suboptimal because screening should balance benefit, harm and resource use; Screen at every visit regardless of interval or prior results is suboptimal because over-screening causes avoidable false positives and harm. A patient-requested PSA is a counselling opportunity, not an automatic order.

Reference: CTFPHC prostate cancer screening guidance