Prostate Cancer Screening
Prostate cancer screening tests have pros and cons. While detecting prostate cancer early may make it easier to treat, the side effects of treatment may outweigh the benefits of early detection. Most prostate cancers grow slowly and do not cause symptoms until they are at advanced stages. Some prostate cancers never advance to the point of causing problems. By considering the potential limitations, risk and benefits, you and your doctor can work together to decide if screening is beneficial for you.
Primary Screening Tools
The following tests are currently used to detect the disease at its earliest stages:
- Prostate-specific antigen (PSA) blood test: This test measures levels of PSA, a protein produced by the prostate gland, in the blood. Elevated PSA levels indicate a greater likelihood of prostate cancer. According to the American Cancer Society, patients with a PSA level between 4 and 10 have a 25 percent chance (approximately) of having prostate cancer.
- Digital rectal exam (DRE): During this exam, the doctor inserts a gloved finger into the rectum to feel for hard, lumpy or abnormal areas of the prostate.
Your doctor may use the results of your PSA test and DRE to determine if additional tests are needed.
Screening Age and Frequency
While oncologists agree that screening for prostate cancer can reduce prostate cancer mortality, it can come at the expense of overdiagnosis and overtreatment of men with cancers that are not life-threatening.
The American Urological Association recommends prostate cancer screening every two years (or more) for men ages 55 to 69. Men with a positive family history of prostate cancer and those of African-American descent may require earlier or more frequent screenings. If needed, your doctor will help you individualize your decisions regarding cancer screening.
The American Urological Association does not recommend routine PSA screening for men age 70 years or older. This testing is also discouraged for patients with less than a 10-year life expectancy.
More Information About Prostate Cancer Screening from Johns Hopkins Medicine
Age-Specific Screening Guidelines
When should you start getting screened for prostate cancer? Your family history is one factor to consider.