Testing for Prostate Cancer: Early Detection and Screening
(Read time: 5 minutes)
This article is not intended to replace professional medical care or advice. If you have any questions or need additional information, please talk with your doctor.
“Should I get screened for prostate cancer?”
It’s a question all men should consider, especially if they have prostate cancer risk factors, such as family history or genetic, lifestyle, or dietary factors.
Fortunately, prostate cancer screening can detect the disease at an early stage, even before symptoms begin to appear. As studies show, the five-year survival rate nears 100% for men who detect prostate cancer at an early stage.
However, while early detection is possible, prostate cancer testing isn’t for everyone. There is some debate in the medical community, so we’ve consolidated a lot of info for you to review. That way, you can discuss the pros and cons of testing at your next appointment with your provider.
What do the experts say about prostate cancer screening?
In 2017, the US Preventive Services Task Force (USPSTF)—an independent, volunteer panel of national experts in disease prevention and evidence-based medicine—issued a recommendation on prostate-specific antigen (PSA-) based screening for prostate cancer.
They embraced more individualized decision-making, raising the grade from a D to a C. A C-grade means medical professionals should offer or provide prostate cancer testing for selected patients depending on individual circumstances:
- Men aged 55-69 years: recommends individuals make informed decisions about whether to undergo periodic PSA-based screening for prostate cancer.
- Men over age 70: recommends against PSA-based screening.
- Advice to clinicians: Educate men on the potential benefits and harms of screening and treatment. Don’t screen patients who don’t express a desire for screening.
The independent group of experts highlighted the potential harms of prostate cancer screening, such as false-positive results that lead to further testing and a possible prostate biopsy.
Types of prostate cancer screening
Prostate cancer screening offers the benefit of potential early detection, which makes the disease much easier to manage and control.
If you’re considering getting tested, you should learn about the different types of prostate cancer screening:
Prostate-specific antigen blood test (PSA test)
What it involves: Your doctor draws a small amount of blood from your arm.
What it measures: The PSA test checks the level of prostate-produced protein (PSA) in your blood.
What you should know: For the average male, PSA levels typically don’t exceed 4 nanograms per milliliter. For individuals with prostate cancer, PSA levels usually rise above this number.
However, a PSA level over four doesn’t guarantee prostate cancer, nor does a PSA below 4 mean you don’t have prostate cancer. PSA levels over 10 indicate a 50% chance of cancer, according to the American Cancer Society.
Note that there is always the potential for a false-positive or false-negative result. The National Cancer Institute states that infections like prostatitis, an enlarged prostate, and medications can all affect PSA levels.
Digital rectal exam (DRE test)
What it involves: Your doctor puts on a glove and lubrication and examines the prostate through the rectum.
What it measures: The DRE test looks for abnormal sizes and irregular shapes and textures in the prostate.
What you should know: The majority of prostate cancers can be detected through finger checking, and the DRE exam helps urologists distinguish between prostate cancer and non-cancerous conditions, like prostate gland enlargement.
However, not all types of prostate cancer can be detected this way, and sometimes additional diagnostic testing is required. Since it’s a finger test, the DRE test has limitations when it comes to detecting nonpalpable cancers.
If the PSA test and/or DRE exam indicates prostate cancer, you may have to undergo a biopsy, which can be performed in an outpatient setting.
For the biopsy, a provider removes microscopic pieces of tissue from the prostate gland. This tissue is then examined for cancerous cells at a diagnostics laboratory.
If the biopsy reveals prostate cancer, the next step is figuring out the best type of treatment for your situation.
Choosing the best treatment option for you
The benefit of prostate cancer screening is its potential to catch prostate cancer at an early stage, when the cancer is still localized and you have numerous options for treatment.
If you have a positive prostate cancer diagnosis, you can choose among three common types of prostate cancer treatment:
- Radiation therapy
- Prostatectomy (surgery)
- Active surveillance
Each type of prostate cancer treatment has its benefits and drawbacks, which is why it’s important to talk with your doctor and support groups about your treatment options.
Getting serious about prostate health
If you’re over the age of 50 or at risk for prostate cancer, getting regular check-ups should be a priority. However, the way you get screened is up to you, and you should weigh the benefits and drawbacks of each screening method with your doctor first.
Similarly, if you’ve been diagnosed with prostate cancer, there is no one-size-fits-all approach to treatment. The best decision can be made once you’ve educated yourself, talked with your doctor, and discussed all your options.
If you’d like to learn more about prostate cancer screening, and where to find free screenings near you, feel free to use the following resources:
- ZERO: Prostate Cancer Testing Near You
- ZERO: Prostate Cancer Learning Resources
- Mayo Clinic: Prostate Cancer Diagnosis And Testing
If you’d like to know what to discuss with your doctor, please download and print out our free discussion guide:Download a prostate cancer treatment discussion guide