How Often Should Prostate Screening Be Done

The Test Is Often Not Needed

Most men with high PSAs dont have prostate cancer. Their high PSAs might be due to:

• An enlarged prostate gland.
• Recent sexual activity.
• A recent, long bike ride.

Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually dont cause symptoms, or death.

Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.

Why A Psa Test Is Done

A PSA test may be done to:

• help find prostate cancer early in men who dont have any signs or symptoms of the disease
• check for cancer in men who have signs or symptoms of prostate cancer
• confirm a diagnosis when other tests suggest prostate cancer
• predict a prognosis for prostate cancer
• predict if cancer has spread outside the prostate
• plan treatment for prostate cancer
• monitor men with prostate cancer who are being treated with active surveillance
• find out if cancer treatments are working
• find out if cancer has come back after treatment

A PSA test is often used together with a digital rectal exam to increase the chance of finding prostate cancer early when it is easier to treat. Using these tests together is better than using either test alone.

What If A Screening Test Indicates The Possibility Of Prostate Cancer

If prostate cancer is suspected, a biopsy will be recommended. During this procedure, a physician inserts a hollow needle through the wall of the rectum to collect prostate tissue samples, which can be evaluated under a microscope for evidence of cancer.

Moffitt Cancer Center offers prostate cancer screening without referrals. To request an appointment with a specialist in our Urologic Oncology Program, call or complete a new patient registration form online.

• BROWSE

You May Like: How Are Fiducial Markers Placed In The Prostate

Psa Density And Psa Density Of The Transition Zone

PSA density is the level of PSA in the blood in relation to the size of the prostate measured during a transrectal ultrasound . It is calculated by taking the PSA level and dividing by the prostate volume. PSA levels are usually higher in men with enlarged prostates. PSAD can help doctors tell which men have prostate cancer and which men have benign prostatic hyperplasia because a high PSAD is more often related to prostate cancer.

PSAD of the transition zone is the level of PSA in the blood in relation to the volume of the transition zone of the prostate. PSAD of the transition zone seems to be more accurate than PSAD of the entire prostate at identifying which men have benign prostatic hyperplasia and which men have prostate cancer.

Prostate Cancer Screening Ages 55 To 69

This is the age range where men will benefit the most from screening.Thats because this is the time when:

• Men are most likely to get cancer
• Treatment makes the most sense, meaning when treatment benefits outweigh any potential risk of treatment side effects

Most men will get prostate cancer if they live long enough. Some prostatecancers are more aggressive others can be slow-growing. Doctors will takeyour age and other factors into consideration before weighing the risks andbenefits of treatment.

You should ask your doctor how often he or she recommends you get screened.For most men, every two to three years is enough.

Depending on the results of your first PSA test, your doctor may recommendyou get screened less frequently.

Read Also: Prostate Cancer Osteoblastic Or Osteolytic

A Prostate Cancer Gene 3 Rna Test May Be Used For Certain Patients

If a man had a high PSA level and a biopsy of the prostate did not show cancer and the PSA level remains high after the biopsy, a prostate cancer gene 3 RNA test may be done. This test measures the amount of PCA3 RNA in the urine after a DRE. If the PCA3 RNA level is higher than normal, another biopsy may help diagnose prostate cancer.

Who Should Have A Psa Test

Talk to your doctor about the PSA test. Make an informed decision about whether the PSA test is right for you by talking with your doctor and considering your personal risk factors.

• If you are at average risk of developing prostate cancer, consider testing from age 50.
• If you are at high risk of developing prostate cancer, consider testing from age 45. Black men and those with a family history of prostate cancer are considered to be at high risk.

Your PSA levels will determine how often you get tested. The decision to stop testing is based on your PSA levels, age and general health.

Also Check: Household Items For Prostate Massage

Health & Wellnessdiagnosed With Prostate Cancer At 37 Man Shares Story To Erase Stigma

This examination lasts 15 to 20 seconds, according to Ehdaie, and is uncomfortable butnot painful. Rettig noted that on its own, the digital exam is not going to add very much, but can be paired with the blood test to give a full picture of the patients health situation.

After that exam is completed and the bloodwork is done, the results are evaluated together.

A decision would be made to either pursue further tests because the screenings suggest there may be something that would be of concern, or they would return at the next scheduled , Ehdaie said.

Related:

What Are The Guidelines For And How Were They Produced

The Consensus statements on PSA testing in asymptomatic men in the UK are a set of recommendations for health professionals. It contains a list of guidelines to help them better support men to decide whether or not to have a PSA test and when and how often this should happen.

Usually, experts look at the results of medical research to help them produce guidelines. But there havent been enough studies about the PSA test to give us all the answers. So until more results from research are available, we needed to get agreement from a large group of health professionals in order to write guidelines to fill some of the gaps. We asked more than 300 health professionals to tell us whether they agreed or disagreed with each guideline. We then made changes to the guidelines until the majority of the health professionals agreed with them. A smaller group of experts then met to talk about the guidelines and helped us produce the final version.

The consensus statements have been endorsed by the British Association of Urological Nurses , the British Association of Urological Surgeons and the Primary Care Urology Society .

We also spoke with men, including some men with prostate cancer and their partners, to find out what they thought about the guidelines, and whether they would help to support men.

This project was funded through charitable funds which were not provided by the pharmaceutical industry or any medical device or treatment company.

Also Check: How To Shrink Prostate Mayo Clinic

Other Factors That Influence Psa Levels

The PSA blood test alone cannot diagnose prostate cancer. It is possible, although rare, to have prostate cancer without raised PSA levels in the blood. A higher-than-normal PSA level doesnt automatically indicate prostate cancer either. A high PSA level is due to cancer in around one in three cases.

PSA levels can be raised by other factors, including:

• , also known as benign prostatic enlargement .

For this reason, the PSA blood test isnt used in isolation when checking for prostate cancer.

Prostate Cancer Screening Ages 40 To 54

The PSA test is a blood test that measures how much of a particular protein is in your blood. Its been the standardfor prostate cancer screening for 30 years.

Your doctor will consider many factors before suggesting when to startprostate cancer screening. But hell probably start by recommending the PSAtest.

While the general guidelines recommend starting at age 55, you may need PSAscreening between the ages of 40 and 54 if you:

• Have at least one first-degree relative who has had prostate cancer
• Have at least two extended family members who have had prostate cancer
• Are African-American, an ethnicity that has a higher risk of developing more aggressive cancers

You May Like: Do Female Have Prostate

How Often Should A Man Get A Digital Prostate Exam

· You can get a prostate exam easily and quickly at your doctors office. Generally, for cancer screenings, your doctor will take a simple blood test. Your doctor might also choose to perform a …

What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening

Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a mans chance of dying from prostate cancer. Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a mans life. Detecting tumors that are not life-threatening

that requires treatment.

Don’t Miss: Define Prostate

What Do The Results Mean

PSA levels may be above the baseline for various reasons other than prostate cancer.

Other factors that can raise PSA levels include:

• older age
• an enlarged prostate â because of benign prostatic hyperplasia , for example
• prostatitis, which is inflammation and swelling of the prostate

Also, people with obesity may have lower PSA readings.

In addition, some medications may reduce PSA levels, including:

• 5-alpha reductase inhibitors, which can help treat BPH
• aspirin, which some people take regularly as a blood thinner
• statins, which help manage cholesterol levels
• thiazide diuretics, a kind of water pill that can help reduce high blood pressure

Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.

High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.

The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.

Prostate Cancer Is The Most Common Nonskin Cancer Among Men In The United States

Prostate cancer is found mainly in older men. Although the number of men with prostate cancer is large, most men diagnosed with this disease do not die from it. Prostate cancer causes more deaths in men than any other cancer except lung cancer. Prostate cancer occurs more often in African American men than in White men. African American men with prostate cancer are more likely to die from the disease than White men with prostate cancer.

Don’t Miss: Super Beta Prostate Advanced Side Effects

Two Main Screening Tests

There are two tests commonly used to screen for prostate cancer:

• The Digital Rectal Exam : A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
• The Prostate Specific Antigen Test: This exam measures the level of PSA in the blood. The levels of PSA in the blood are often higher in men who have prostate cancer. The PSA level may also be high in other conditions that affect the prostate.Usually, the higher the bloods PSA level is, the more likely it is that a prostate problem is present. But other factors, such as age and race, also can raise PSA levels. PSA levels also can be impacted by certain medical procedures, some medications, an enlarged prostate or a prostate infection.

  Since your PSA level may be high for other reasons, your doctor will need to interpret the test results.

If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will need to do a prostate biopsy to find out. This means a sample of your prostate tissue will be removed with a needle and sent to a lab, where a specialist will determine if it contains cancer cells.

What Is A Normal Psa Test Result

There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.

However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer . In addition, various factors can cause a mans PSA level to fluctuate. For example, a mans PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugsincluding finasteride and dutasteride , which are used to treat BPHlower a mans PSA level. PSA level may also vary somewhat across testing laboratories.

Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of White men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.

In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a mans PSA level over time may also be a sign of prostate cancer.

Don’t Miss: Tamsulosin Ejaculation

What Age Should Men Be Screened For Prostate Cancer

The Prostate Cancer Foundation recommends that Black men or men with a family history of cancer be screened at the age of 40 otherwise, the organization advises getting screened at 45. The American Cancer Society recommends that men at “average risk” be screened at the age of 50, while “men at high risk of developing prostate cancer” like Black men and men who have a first-degree relative, like a father or brother, who were diagnosed with prostate cancer before the age of 65, be screened at 45. Men at “even higher risk” should be screened at 40.

In 2018, the U.S. Preventive Services Task Force issued a recommendation advising men to start talking about screenings with their doctors at the age of 55.

What Is Screening For Prostate Cancer

Some men get a PSA test to screen for prostate cancer. Talk to your doctor, learn what is involved, and decide if a PSA test is right for you.

Cancer screeningexternal icon means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.

If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your personal risk factors.

There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.

Recommended Reading: Prostatic Neoplasms

Different Factors Increase Or Decrease The Risk Of Developing Prostate Cancer

Anything that increases a person’s chance of developing a disease is called a risk factor. Anything that decreases your chance of getting a disease is called a protective factor.

For information about risk factors and protective factors for prostate cancer, see the PDQ summary on Prostate Cancer Prevention.

At What Age Should You Get Screened For Prostate Cancer

The following prostate cancer screening guidelines apply to men expected to live at least ten years.

Men ages 45 to 49 should have a baseline PSA test.

• If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.
• If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.
• If the PSA level is less than 1 ng / mL, men should see their doctor for another PSA test between the ages of 51 and 55.

Men ages 50 to 59 should have their PSA level checked.

• If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.
• If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.
• If the PSA level is less than 1 ng / mL, men should see their doctor for another PSA test at age 60.

Men ages 60 to 70 should have their PSA level checked.

• If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate.
• If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every two to four years.
• If the PSA level is less than 1 ng / mL, no further screening is recommended.

Men ages 71 to 75 should talk with their doctor about whether to have a PSA test. This decision should be based on past PSA levels and the health of the man.

Don’t Miss: Is Cialis Good For Bph