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Is Prostate Cancer Screening Right For You?

If you are considering having a prostate cancer screening, the best place to start is talking with your doctor to find out the pros and cons of screening and whether your risk factors justify being screened.

Prostate Cancer Screening Tests

Two tests are commonly used to help detect prostate cancer in early stages so treatment can begin as soon as possible:

• The prostate-specific antigen (PSA) blood test. This exam measures the levels of PSA – a substance made by the prostate – in the blood. High PSA levels can be a sign of prostate cancer. Other conditions and causes also can elevate PSA levels, such as enlarged prostate, prostate infection, certain medical procedures, or certain medications.

Age and race also can affect PSA levels. And levels naturally vary person to person. Keeping these variables in mind, your doctor will interpret your results, and if your PSA test is abnormal, could recommend you have a biopsy to check for prostate cancer.

• The digital rectal exam. In this exam, your health care provider inserts a gloved, lubricated finger into the rectum to feel for any lumps or abnormalities in the prostate. Your provider also will feel for the size of the prostate.

Guidelines For PSA Screening

The American Urologic Association recommends these guidelines for PSA screening, by age:

• Under 40. No screening needed.
• 40 to 54. Get a PSA if you are at risk due to being African-American, having a family history of prostate cancer, or a family history of BRCA1 or BRCA2 gene defects, which are linked to increased occurrence of breast, ovarian, and prostate cancer.
• 55-69. Get a baseline PSA level, after which you and your doctor will discuss whether you should have a follow-up test in a year or two, based on your overall risk and preferences
• 70+. No routine screening is recommended. However, some men age 70+ who are in excellent health may benefit from prostate cancer screening.

Your doctor will revisit with you the pros and cons of being screened as new information is learned about the benefits and risks of prostate cancer testing – and as your health status changes.

Follow-up Prostate Cancer Screenings

If your screening does not find prostate cancer, your health care provider may recommend rescreening at intervals based on your PSA blood test results:

• Every 2 years for a PSA of less than 2.5 ng/mL
• Yearly for a PSA level of 2.5 ng/mL or higher

Source: American Urologic Association; American Cancer Society; Centers for Disease Control and Prevention