Early Detection for Prostate Cancer

It has been common practice since the prostate specific antigen test (PSA) was created to use this as a screening tool for prostate cancer in conjunction with a digital rectal exam (DRE). 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 the probability of cancer. Because the DRE can sometimes find cancers in men with normal PSA levels, doctors suggest that you have both tests.

The American Cancer Society recommends annual screening (a PSA test and digital rectal exam) for all men after age 50 who have a life expectancy of at least 10 years. Men who are at higher-than-average risk—including African American men and men with a family history of prostate cancer—should begin annual screening at age 40.

The U.S. Preventive Services Task Force (USPSTF) warns however that even though there is good evidence that PSA screening can detect early-stage prostate cancer, there is "mixed and inconclusive evidence that early detection improves health outcomes." Screening may cause "frequent false-positive results and unnecessary anxiety, biopsies, and potential complications of treatment of some cancers that may never have affected a patient's health." Therefore, the USPSTF believes there is insufficient evidence to support whether the benefits of regular screenings outweigh the potential harms.

SCCA's Cancer Prevention Clinic providers are faculty at University of Washington School of Medicine as well as Fred Hutchinson Cancer Research Center members. They are well equipped to work with you to discuss the potential benefits and risks of screening and to determine if regular screenings are appropriate for you.