From the Guidelines
A Prostate-Specific Antigen (PSA) test should be done to screen for prostate cancer in men and to monitor treatment effectiveness in those already diagnosed, with the decision to test made individually with healthcare provider guidance, considering factors such as age, risk level, and patient preferences 1.
Importance of PSA Testing
The PSA test measures the level of PSA, a protein produced by the prostate gland, in a man's blood. Generally, men should discuss PSA screening with their doctor starting at age 50, or earlier (around age 45) for those at higher risk, including African American men and those with a family history of prostate cancer.
Procedure and Interpretation
The test involves a simple blood draw, with results typically reported in nanograms per milliliter (ng/mL). Normal PSA levels are usually below 4 ng/mL, though this can vary by age and other factors. Elevated PSA levels may indicate prostate cancer, but can also result from benign conditions like prostatitis, benign prostatic hyperplasia (BPH), or recent ejaculation.
Benefits and Limitations
The PSA test is valuable because prostate cancer often develops without symptoms in early stages, and early detection significantly improves treatment outcomes. However, it's essential to understand that the test isn't perfect and may sometimes lead to unnecessary procedures, which is why the decision to test should be made individually with healthcare provider guidance 1.
Guidelines and Recommendations
The American Cancer Society and other organizations recommend that men discuss the potential benefits and limitations of PSA testing with their healthcare provider, considering their individual risk factors and preferences 1. Men at high risk, including those with a family history or of African American descent, may need to start testing earlier, around age 45 1.
From the Research
Reasons for Prostate-Specific Antigen (PSA) Testing
- Early detection of prostate cancer: PSA testing can help detect prostate cancer at an early stage, when it is more treatable 2, 3.
- Identification of high-risk individuals: PSA testing can help identify individuals who are at high risk of developing prostate cancer, such as those with a family history of the disease or African American men 4, 5.
- Monitoring of prostate health: PSA testing can be used to monitor the health of the prostate gland and detect any changes that may indicate the presence of cancer 2, 3.
Benefits of PSA Testing
- Improved detection of organ-confined cancer: PSA testing can help detect prostate cancer at an early stage, when it is still confined to the prostate gland 3.
- Reduced risk of metastatic prostate cancer: PSA testing can help reduce the risk of metastatic prostate cancer by detecting the disease at an early stage 6.
- Improved treatment outcomes: Early detection of prostate cancer through PSA testing can improve treatment outcomes and reduce the risk of complications 2, 3.
Target Population for PSA Testing
- Men aged 55-69 years: The US Preventive Services Task Force recommends that men aged 55-69 years discuss the benefits and harms of PSA testing with their clinician and make an individual decision about whether to undergo testing 6.
- High-risk individuals: Men with a family history of prostate cancer or African American men may benefit from earlier or more frequent PSA testing 4, 5.
- Men with symptoms: Men who are experiencing symptoms such as difficulty urinating or painful urination may benefit from PSA testing to rule out prostate cancer 3.