Prostate Cancer Screening

Men should speak with their physicians in order to make an informed decision about prostate cancer screening. The American Cancer Society recommends that men at average risk for developing prostate cancer should have a discussion about screening at the age of 50. Men at high risk for developing prostate cancer, such as African-Americans and individuals with as strong family history of prostate cancer, should have this discussion at the age of 45.

PSA Testing & DRE

Men who choose to be screened for prostate cancer should receive a prostate-specific antigen (PSA) test. This test is widely available and only requires a small amount of blood to be drawn. Digital rectal exam may also be performed in addition to a PSA test. During DRE, a physician wearing a lubricated glove will insert a finger into the prostate to inspect for nodules or enlargement of the prostate.

Prostate-specific antigen, or PSA, is a protein produced in the prostate gland. The PSA test measures levels of PSA in the blood. The higher the PSA level, the more likely it is that prostate cancer is present. However, prostate cancer can be present with lower PSA levels and elevated levels of PSA can be caused by conditions besides prostate cancer, such as infection or prostate enlargement.

PSA Test Results

In the past, physicians used a PSA level of 4.0 ng/mL as a benchmark. Levels above that benchmark were considered high while levels below were considered normal. Now, when determining whether a PSA level above 4.0 ng/mL could be indicative of cancer, physicians consider a number of factors including age, race, family history and diet.

If a man with no symptoms of prostate cancer has an elevated PSA level at the time of first screening, his physician will most likely recommend routine PSA testing and DRE. If a nodule is detected or if PSA levels continue to rise during repeat screening, his physician may recommend a diagnostic imaging exam, like x-ray or ultrasound, or biopsy, a procedure that removes tissue for sampling, to determine the cause.