Prostate Cancer Screening

A single test cannot detect prostate cancer. PSA blood tests and digital rectal examinations (DREs) are the two most common tests.

• Prostate-specific antigen (PSA)

  PSA tests measure the level of PSA in your blood. The test does not explicitly test for cancer. The prostate gland primarily produces PSA. Depending on your age, there is a normal range. PSA levels above the typical range may indicate the presence of prostate cancer. However, two-thirds of cases of elevated PSA are caused by non-cancerous conditions, such as prostatitis and benign prostatic hyperplasia.

  Ask your doctor about the risks and benefits of a PSA test if you do not have any symptoms of prostate cancer.

  Although some studies suggest PSA reduces mortality on a population-wide basis, the test detects many cancers that would have caused no symptoms or harm to the patient. Overdiagnosis is a term used to describe this situation. Prostate cancer may be overdiagnosed, leading to unnecessary treatments that may cause sexual impotence, urinary incontinence, and bowel problems.

  The potential benefit of detecting prostate cancer at an early stage must be balanced against the possibility that detection and treatment may not be necessary. Treatment may change your lifestyle, but it may also save your life.

  Discuss your decision with your doctor before deciding whether to undergo a test. Make sure you obtain quality information to make an informed decision.

• Digital rectal examination (DRE)

  A urologist generally performs a DRE to feel the prostate. A DRE is no longer recommended as a routine test for men without symptoms of prostate cancer. However, it can be used to detect any changes in the prostate before a biopsy is performed.

  A transrectal ultrasound (TRUS) biopsy and magnetic resonance imaging (MRI) scan are usually necessary to confirm a diagnosis of prostate cancer if either of these tests indicates an abnormality.