What Age Should I Start Getting A Prostate Exam
For African-American men and men with a family history of prostate cancer, it is recommended that tests be given starting at age 40. If you have urination problems or if the DRE or PSA test indicates that you might have a problem, you will probably be given additional tests that may require some preparation.
What Happens During A Prostate Exam
If youve never had a DRE before, you may be concerned about what happens during a prostate exam and what it feels like. Dont worryit is not a painful experience.
Before performing a prostate exam, your healthcare provider will ask you to remove your clothes from the waist down and will provide you with a gown to wear. During the DRE, you will stand and bend at the waist or lie on your side with your knees bent. Your healthcare provider will apply lubricant to a gloved finger, gently insert it into your rectum, and sweep their finger along the wall of the rectumthis allows them to feel any abnormalities in the prostate.;
Your provider may press down on your lower abdomen during this process, potentially causing mild discomfort and the urge to urinatethis is normal. The good news is these sensations only last a few minutes.;
Another Option: Digital Rectal Exams
Most prostate biopsies are driven by PSA results. Urologists also use the digital rectal exam, or DRE.
“The American Urological Association hasn’t recommended rectal exams because there has yet to be a randomized trial in which some men get the rectal exam and some don’t. Based on who lives and dies, this would show if rectal exams have value,” says Dr. Freedland. “Many people, myself included, think they do have value. It’s part of the evaluation that we use even if it’s not officially in our guidelines.”
The DRE may cause momentary discomfort, but it can also detect prostate cancer for those patients with normal PSA levels. “We use the exam because we think it should work and be helpful, even if it hasn’t been studied,” Dr. Freedland adds. “Most people are screened with PSA and DRE.”
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Who Should Be Screened And When
A variety of factors determine when and who should be screened. “Prostate screening is considered for men ages 55 to 69 but can be continued above age 70 in healthy men. Screening for prostate cancer may be considered for men between the ages of 40 and 54 in those at higher risk for cancer ,” says Dr. Christiansen. “Men outside the age range of 55 to 69 may still need to undergo prostate-specific antigen blood testing or a prostate exam to assist with the diagnosis and management of benign prostatic hyperplasia or other urologic conditions.”;;The American Urologic Association guidelines do not recommend routine screening in men between ages 40 to 54 years who are at average risk. For men younger than age 55 at higher risk, prostate cancer screening decisions should be individualized. A routine screening interval of two years or more may be preferred over annual screening in those men who have participated in shared decision making with their doctor.
Whats The Recommended Age For Your First Prostate Exam
Starting at age 50, all men should discuss getting a prostate exam with their doctor.;
The reason for this is prostate cancer. In the UK, about one in eight men will be diagnosed with this in their lifetime. It mainly affects men aged 50 plus, but your risk increases as you get older, and the most common age to be diagnosed is between 65 and 69 years. Most men with early prostate cancer dont have any noticeable signs or symptoms.;
The exception to this rule is if you are experiencing symptoms, or if your genetics predispose you as higher risk. Doctors are increasingly finding the tendency towards some prostate cancers can be inherited from your fathers family. Additionally, black men are at a higher risk, with one in four getting prostate cancer in their lifetime.;
If youre experiencing no symptoms, heres the recommended age for prostate exam:
- If you have a family history, first prostate exam at age 40
- If you are black, first prostate exam at age 45
- If you have no family history and youre not black, first prostate exam at age 50
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Who Should Get A Digital Rectal Exam
Not all medical institutions agree on when men should begin screening for prostate cancer or even if a DRE should be part of the screening.
To help detect prostate cancer in its early stages, the American Cancer Society recommends that men talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested.
For most men at average risk, discussions about screening begin at age 50. However, some doctors recommend that men at higher risk of prostate cancer — African-American men or men with a family history of prostate cancer — start screening earlier.
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Rettig said that someone who has a “strong family history” of early onset prostate cancer might want to talk to their primary care provider or other health care practitioner earlier in life, while someone with less risk might prefer to wait.
The guidelines for how often men should be screened again also vary. If you have a high prostate-specific antigen , a protein made by cells in the prostate gland, you may be recommended to come back for more frequent screenings, but those with lower PSA levels might only be advised to come back every four years or so.
“If you’re 55 and have you have a PSA of less than one, you can wait four years to get screened again,” Rettig explained. “Alternatively, if you’re 45 and have a PSA of two and a half, that might be someone who might get a biopsy or be re-screened within the year. … How frequently one would be prescreened is really contingent upon the specifics of the patient.”
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Screenings Can Lead To High Costs
The cost for a PSA test is fairly lowabout $40.
If your result is abnormal, the costs start adding up. Your doctor will usually refer you to a urologist for a biopsy. Costs may include:
- A consultation fee .
- An ultrasound fee .
- Additional professional fees .
- Biopsy fees .
If the biopsy causes problems, there are more costs. You might also have hospital costs.
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.
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Early Cancer Detection Can Save Lives And Cut Treatment Costs But When Should You Start Having Prostate Exams And Do You Need To Have Them At All
When it comes to screening for prostate cancer, some men may be confused or apprehensive about beginning to get annual exams.
As prostate cancer affects one out of every six men, the American Cancer Society and other leading medical organizations recommend older men discuss having annual prostate cancer screenings with their primary care doctor to help detect the disease early. Early detection of the disease helps cure it in 90 percent of cases.
Generally, it is recommended that men with an average risk of prostate cancer start being screened with a digital rectal exam and PSA blood-level exam when they hit the age of 50. African-American men and men who have a father, brother or son who were diagnosed with prostate cancer when they were younger than 65 are at higher risk and should start screenings at age 40. Men who have had more than one of these close relatives diagnosed before age 65 are at even higher risk.
Men: Cancer Screening Exams By Age
These exams are for men at average risk of cancer.
Take this checklist to your next doctors appointment. Your doctor can help you develop a more tailored screening plan if needed.
These exams are for men at average risk of cancer. If you believe you may be more likely to develop cancer because of your personal or family medical history, visit our screening guidelines page to learn about exams for men at increased risk.
Ages 40-49
- Beginning at age 40, you should speak with your doctor about the benefits and limitations of prostate screening.
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year starting at age 45 to check for prostate cancer if you are African American or have a family history of prostate cancer.
Ages 50-75
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year to check for prostate cancer
- Colonoscopy every 10 years or virtual colonoscopy every 5 years to check for colorectal cancer
Age 76 and older
If youre age 76 to 85, your doctor can help you decide if you should continue screening. MD Anderson does not recommend cancer screening for men age 85 and older.
All Ages
Speak with you doctor about cancer screening exams for lung and skin cancers. Exams are available for those at increased risk.
Regardless of your age, practice awareness.; This means you should be familiar with your body so youll notice changes and report them to your doctor without delay.;
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Dr. Behfar Ehdaie, a urologic surgeon specializing in prostate cancer at Memorial Sloan Kettering Cancer Center in New York, said that these varying guidelines are due to the different risk factors that each person faces. Things like family history, environmental factors, race and more can all come into play when it comes to assessing prostate cancer risk.
“There are specific patient level factors that have to go into that decision, including family history, comorbidities, and life expectancy,” said Ehdaie, who said that people who are not expected to live more than another decade may not be advised to get screened. “And of course, the patient’s own preferences are taken into account, their goals, what they want to achieve.”
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
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Prostate Specific Antigen Test
A blood test called a prostate specific antigen test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.
As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.
PSA levels also can be affected by
- Certain medical procedures.
Should You Get A Prostate Exam
Ideally, you should discuss the pros and cons of getting a prostate exam with your doctor.
Cancer screening has risks you need to understand before starting the process.
One of them is overdiagnosis and experiencing undesired side effects of prostate biopsies.
There are more risks than benefits in prostate exams for patients above 70 years.
Thats why they are often advised against screening.
After 55 years, patients with urinary symptoms should get screened.
Those with a family history of prostate cancer may also require screening .
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Is Going To The Bathroom Frequently A Sign Of Prostate Cancer
Thats one of the challenging things; having urinary symptoms is very rarelyalmost nevera sign of prostate cancer. Having urinary symptoms means you should probably be evaluated for an enlarged prostate, also known as;benign prostatic hyperplasia . We can treat your urinary symptoms and help you pee better.;
If urinary symptoms bring men to the doctor, we can discuss screening for prostate cancer. Thats important because not all men will go to a doctor until theres something wrong with them. And prostate cancer screening really is the only way to detect prostate cancer, because its almost always asymptomatic.;
Your First Prostate Exam
Beginning at age 40, you should speak with your doctor about the benefits and limitations of prostate screening. If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year starting at age 45 to check for prostate cancer if you are African American or have a
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Risks And Benefits Of Prostate Cancer Screening
There are two main benefits of prostate cancer screening.;
One is potentially preventing death from prostate cancer. Many men have prostate cancer without experiencing symptoms, so screening can potentially identify prostate cancer early on when it can be treated more easily.;
Another benefit of screening and early detection is potentially catching prostate cancer in its early stages, allowing for more effective treatment. Earlier treatment can help prevent prostate cancer from spreading beyond the prostate , which can cause several symptoms.
Unfortunately, there are drawbacks to prostate cancer screening. The DRE is not very sensitive or specific. This means that people who have prostate cancer can still have a normal DRE, while patients with an abnormal DRE may not have prostate cancer. For these reasons, healthcare providers are no longer performing DRE alone for routine prostate cancer screening and relying instead on the PSA test .;;
PSA testing also has limitations in screening for prostate cancer. Elevated PSA levels do not only occur in prostate cancer. Prostatitis or an enlarged prostate can also cause PSA levels outside the normal range. Abnormal test results can ultimately lead to undue anxiety and further testing that may prove unnecessary .;
Another problem with the PSA test is the potential for overdiagnosis and overtreatment. Screening uncovers patients with prostate cancer who would otherwise never have had any issues resulting from the disease.;
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This examination lasts “15 to 20 seconds,” according to Ehdaie, and is “uncomfortable” but “not 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 patient’s 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.
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What Is A Prostate Cancer Screening Like
A prostate cancer screening can be conducted in one of two ways. The first, a PSA test, is a simple blood draw. The second is a brief rectal exam that takes less than 30 seconds to perform.
“For a screening, if a patient comes and asks for a prostate cancer screening, it begins with a blood test,” said Ehdaie. “It’s a small vial of blood, and then a medical history and physical examination. In the physical examination there will be a digital rectal examination in which the physician’s finger is inserted into the rectum to feel the prostate.”
What Do You Want Men To Know About Prostate Cancer
The important thing to know is that, if you live long enough, you will probably get prostate cancer. If you live into your 80s, about 80 percent of men have some sort of prostate cancer. That doesnt mean theyre going to die from prostate cancer because, as a percentage, very few men die from prostate cancer. It means its important to be aware of it and consider screening early, so if its a high-grade type, we can identify it and treat it.;
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When To Get A Prostate Cancer Screening
A prostate screening can help your doctor find prostate cancer early, but youll need to decide if the benefits of the exam outweigh the risks. Have a discussion with your doctor about prostate cancer screenings.
The U.S. Preventive Services Task Force now recommends that men ages 55 to 69 decide for themselves whether to undergo a prostate-specific antigen screening test, after talking it over with their doctor.
They recommend against screening for men at or above the age of 70.
The American Cancer Society strongly recommends that no one be screened without discussion of the uncertainties, risks, and potential benefits of prostate cancer screening.
They give these specific recommendations for the date at which these discussions with a healthcare provider should take place:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
You should also speak with your doctor about a prostate exam if youre experiencing symptoms of a prostate problem, such as frequent or painful urination or blood in your urine.
After this discussion, if you decide to get a prostate cancer screening, the ACS and the American Urologic Association recommend getting a prostate-specific antigen blood test.