Early Detection of Prostate Cancer
Since the prostate-specific antigen (PSA) test was introduced in the late 1980s, doctors have commonly used it to screen for prostate cancer. The PSA test is a blood test that measures a protein released in the blood by prostate cells. Both normal and malignant (cancerous) prostate cells secrete the protein, but higher PSA levels may indicate cancer.
During the last few years, the PSA test has come under fire because of concerns that it has led to over-diagnosis and overtreatment. In 2013, 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.1
Seattle Cancer Care Alliance urologic oncologists concur with the AUA recommendations (below). If you have any questions about whether the PSA test is right for you, talk with your doctor about the benefits and risks.
Early Detection of Prostate Cancer: AUA Guidelines
Below is a summary of the AUA prostate cancer screening guidelines.
Men Under Age 40
PSA screening is not recommended for men under 40.
Men Age 40 to 54
Routine PSA screening is not recommended for men age 40 to 54 who are at average risk for developing prostate cancer.
Men Ages 55 to 69
Men age 55 to 69 who are considering prostate cancer screening should talk with their doctors about the benefits and risks of PSA testing and proceed based on their personal values and preferences.
Men Age 70 or Older and Men with a Life Expectancy of Less than 10 to 15 Years
Routine PSA screening is not recommended for men age 70 or older or for men of any age with a life expectancy of less than 10 to 15 years.
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 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 of prostate cancer
- African-American race
- Older age
- Prior biopsy
- Prostate cancer symptoms
- 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
Many of these symptoms also occur with a common urological condition known as benign prostatic hyperplasia, which is not cancer. If you are experiencing any of these symptoms, call your doctor.
1. “Early Detection of Prostate Cancer: AUA Guideline,” American Urological Association, accessed 6/18/2013, http://www.auanet.org/education/guidelines/prostate-cancer-detection.cfm.