Should chiropractors screen for prostate cancer: Controversy, risk and benefits of prostate-specific antigen test

Objectives: Prostate cancer (PC) is the most common neoplasm among males in the United States. Studies have established its relationship with back problems which is the most common musculoskeletal patient complaint seen by the chiropractic profession. In particular, screening for PC has emerged as a current and contentious issue in health care and public health. One of the most popular screening methods is the prostate-specific antigen (PSA) test whose validity in terms of risk and benefits remain controversial. Given the association of PC with and its metastasis to the lumbar spine creating low back pain symptoms, it is important for the chiropractic profession to be abreast of the best practices for its diagnosis. The purpose of this study is to conduct a meta-analysis (MA) on the benefit/risk of PSA-based screening as an update of existing literature. Method: Both electronic search of databases (PUBMED, MEDLINE, CANCERLIT, EMBASE, CENTRAL, PROSTATE Registrar) and hand search of specific bibliographies will be conducted for trials (RCTs) on PSA-based screening/no screening of PC including risk/benefits. Studies would be eligible if they are RCTs on this topic. Focus will be on studies conducted since the last published meta-analysis on this topic. All identified manuscript will undergo full text review and data from accepted studies will be summarized and analysis using SPSS. Conclusion: This study has the potential of confirming or refuting existing claims on the benefits/risk of PSA-based screening for PC as well as engaging the chiropractic profession in the ongoing debate on this issue.