Prostate cancer screening


Definition

Cancer screenings can help find signs of cancer early, before you notice any symptoms. In many cases, finding cancer early makes it easier to treat or cure. However, at present it is not clear if screening for prostate cancer is helpful for most men. For this reason, you should speak with your health care provider before having a prostate cancer screening.

Alternative Names

Prostate cancer screening - PSA; Prostate cancer screening - digital rectal exam; Prostate cancer screening - DRE

Types of Screenings

Prostate-specific antigen (PSA) test is a blood test that checks the level of PSA in your blood.

Digital rectal exam (DRE) is a test in which your provider inserts a lubricated, gloved finger into your rectum. This allows the provider to check the prostate for lumps or unusual areas. Most cancers cannot be felt with this type of exam, at least in the early stages.

In most cases, the first step of prostate cancer screening is the PSA test but not a DRE because the added value of DRE for screening is very small.

Benefits and Risks of Screenings

The benefit of any cancer screening test is to find cancer early, when it is easier to treat. But the value of PSA screening for prostate cancer is debated. No single answer fits all men.

Prostate cancer often grows very slowly. PSA levels can begin to rise years before a cancer causes any symptoms or problems. It is also very common as men age. In many cases, the cancer will not cause any problems or shorten a man's life span.

For these reasons, it is not clear if the benefits of routine screenings outweigh the risks or side effects of being treated for prostate cancer once it is found.

There are other factors to think about before having a PSA test:

Who Needs Screenings

Measuring the PSA level can increase the chance of finding prostate cancer when it is very early. But there is debate over the value of the PSA test for detecting prostate cancer. No single answer fits all men.

If you're 55 through 69 years old, before having the test, talk to your provider about the pros and cons of having a PSA test. Ask about:

If you are age 55 or younger, screening is not generally recommended. You should talk with your provider if you have a higher risk for prostate cancer. Risk factors include:

For men older than age 70, most recommendations are against screening.

References

Carter HB. American Urological Association (AUA) guideline on prostate cancer detection: process and rationale. BJU Int. 2013;112(5):543-547. PMID: 23924423 pubmed.ncbi.nlm.nih.gov/23924423/.

National Cancer Institute website. Prostate cancer screening (PDQ) - health professional version. www.cancer.gov/types/prostate/hp/prostate-screening-pdq#section/all. Updated February 18, 2022. Accessed October 28, 2022.

Nelson WG, Antonarakis ES, Carter HB, DeMarzo AM, DeWeese TL. Prostate cancer. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 81.

US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Screening for prostate cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(18):1901-1913. PMID: 29801017 pubmed.ncbi.nlm.nih.gov/29801017/.


Review Date: 8/15/2022
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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