Since the prostate-specific antigen test (PSA) was introduced in the late 1980s it has been common practice to use it as a screening tool for prostate cancer. The PSA is a blood test that measures a protein that is released in the blood when there are prostate cancer cells present. Although normal and malignant prostate cells secrete the protein, higher PSA levels may indicate a higher probability of cancer.
During the last few years, however, the PSA test has come under fire because of concerns that it has led to over-diagnosis and overtreatment. Recently, the American Urological Association (AUA) released a new set of PSA screening guidelines for various groups of men based on their age, health, and risk profile.
SCCA’s urologic oncologists concur with the AUA recommendation (below) and suggest that if you have any questions about whether the PSA test is right for you that you talk to your doctor to determine the benefits and risks of PSA testing.
Early Detection of Prostate Cancer: AUA Guidelines
Below is a summary of the AUA's recommended prostate cancer screening guidelines. Click here to view their complete recommendation.
Men Under Age 40
PSA screening is not recommended for men under 40.
Men Ages 40 to 54
Routine PSA screening is not recommended for men between ages 40 and 54 years who are at average risk for developing prostate cancer.
Men Ages 55 to 69
Men ages 55 to 69 years old who are considering prostate cancer screening should talk with their doctors about the benefits and harms of PSA testing and proceed based on their personal values and preferences.
Men Age 70 or Older or Men with Less Than a 10- to 15-year life expectancy
Routine PSA screening is not recommended for men over age 70 or any man with less than a 10- to 15-year life expectancy.
Some men over age 70 who are in excellent health may benefit from prostate cancer screening and should talk with their doctors about the benefits and risks of PSA testing.
Men at Higher Risk of Prostate Cancer
Men who are at a higher risk for developing prostate cancer should discuss their risk with their doctor and assess whether PSA testing is right for them.
Risk factors include:
- Family history
- African American race
- Prior biopsy
- Prostate cancer symptoms
- A high-fat diet
Symptoms of prostate cancer include:
- Weak or interrupted flow of urine
- Urinating often (especially at night)
- Difficulty urinating
- Pain or burning during urination
- Difficulty in having an erection
- Painful ejaculation
- Blood in urine or semen
- Frequent pain or stiffness in the lower back, hips or upper thigh
Note that many of these symptoms are also seen with a common urological condition known as benign prostatic hyperplasia (BPH). If you are experiencing any of these symptoms, call your doctor.