The prostate specific antigen (PSA) test can detect early stage cancer when it is more likely to be cured or controlled. Since it was first used in the 1980s, deaths from prostate cancer have fallen about 30 percent. Even so, some question the merits of PSA screening. Many are confused by concerns raised about over-detection and over-treatment. Men worry about side effects of biopsy and treatment. They wonder if it is worth risking your sex life and bladder control when even experts cannot always agree!
Prostate cancer screening consists of:
- A blood test that measures PSA level and
- A physical exam of the prostate
Screening cannot prove you have prostate cancer, but abnormal results may suggest you need more tests.
At this time, the PSA test is still the best way to detect prostate cancer at an early stage.
Talk with your doctor who knows the most about your health and history. Screening risks and benefits vary with age, ethnic group, previous biopsy results and other factors.
Our screening guideline aligns with the American Urological Association. This is the national specialty organization trusted by prostate health experts at Gundersen Health System.
All men should be offered a baseline PSA level at the age of 40.
Future test results will be compared with this. Find out what your version of normal is before aging and other factors affect your PSA.
A digital (finger) rectal exam (DRE) and PSA should be offered each year to men over 50 who have
- Average risk of prostate cancer and are likely to live at least 10 years
- No other symptoms of prostate problems and are likely to live 10 years
A digital (finger) rectal exam (DRE) and PSA should be offered each year to men 40 and older who
- Are African-American
- Have a first degree sibling (father, brother or son) with prostate cancer
How often you are rescreened is up to you and your doctor. If your PSA remains less than 1.0 and if you have no other symptoms, a PSA test every other year may be enough.
PSA screening benefits
- This simple blood test is usually reliable and accurate.
- It helps detect small cancers that cannot be found with a physical exam.
- Finding cancer early may improve chances of survival or prevent complications of advanced prostate cancer.
PSA screening risks
- Infection, enlargement (benign prostatic hyperplasia or BPH) and other prostate conditions also raise PSA. A false positive can lead to extra worry and unnecessary procedures.
- Cancers that might not cause death or disability may be detected and treated.
- PSA does not always signal the presence of cancer. In rare cases, a man with prostate cancer can have a normal PSA. This is why a DRE is also needed.
To biopsy? Or not?
An abnormal PSA result does not always mean you need a biopsy. Your urologist will help you decide whether to have one based upon your age, family history, and overall health.