Screening for Prostate Cancer

The purpose of screening is to find and treat diseases early. They are given to people who may be at high risk, but who don’t have problems.

Screening Guidelines and Tests

A blood test called PSA may be used to screen for prostate cancer. You will need to consider many factors before taking a PSA test. First, there isn't a clear normal level of PSA. This can lead to:

  • False positive—Some men may have raised levels, but are perfectly healthy. This could lead to more tests and worry before it's confirmed that cancer isn’t there.
  • False negative—PSA is normal, but cancer is there. This may give you a false sense of security and keep you from getting it treated.

Second, many types of prostate cancer grow very slowly. A PSA test may show a small tumor that's not causing any problems. This would not impact health before the natural end of life. A positive PSA test, even if cancer is there, may lead to unneeded tests and procedures for a cancer that would have not needed to be treated. Because of this, most organizations guide men to talk to their doctors about the risks and benefits of PSA screening.

The PSA test measures the levels of PSA in your blood. PSA is a type of protein. It’s made in the prostate gland and released into the bloodstream. Outside of cancer, higher PSA levels may happen because of:

If your PSA is elevated, it doesn't mean cancer is present.

Your doctor may:

  • Do a digital rectal exam to check the size of the prostate
  • Have you take the same test at a later date
  • Do an ultrasound
  • Have your urine tested
  • Want you to have a prostate biopsy to look for cancer
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References

Finding prostate cancer early. American Cancer Society website. Available at: https://www.cancer.org/cancer/prostate-cancer/early-detection/finding-prostate-cancer-early.html. Updated April 14, 2016. Accessed October 29, 2018.
Prostate cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/prostate-cancer. Updated October 2017. Accessed October 29, 2018.
Prostate cancer screening. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114483/Prostate-cancer. Updated October 18, 2018. Accessed October 29, 2018.
Prostate cancer screening—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/prostate/patient/prostate-screening-pdq. Updated February 22, 2018. Accessed October 29, 2018.
What tests can detect prostate cancer early? American Cancer Society website. Available at: https://www.cancer.org/cancer/prostate-cancer/early-detection/tests.html. Updated April 14, 2016. Accessed October 29, 2018.
4/1/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114483/Prostate-cancer: Choosing wisely. EBSCO DynaMed Plus website. Updated October 18, 2018. Accessed October 29, 2018.
Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 10/29/2018

 

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