Screening PSA levels in men.
Prostate specific antigen, or PSA, is a protein produced by the prostate. Screening PSA levels in men has become a standard tool in the detection of prostate cancer, however, the PSA blood test is only one means used in determining a cancer diagnosis.
Traditionally, when PSA levels higher than 4.0 ng/mL were found in the blood, this was considered suspect and additional testing was ordered. In the past, this typically included an immediate prostate biopsy. Today, physicians know that elevated PSA levels are also influenced by other prostate conditions including inflammation (prostatitis), an enlarged prostate (benign prostatic hyperplasia), and infection. All of these conditions account for abnormal PSA levels.
Over the years, that has been much debate and caution against establishing routine PSA screenings for the general population of men. Much of this was influenced by several instances of false-positive readings that led to unnecessary biopsies, treatments, and complications. In reality, screening PSA levels in men is only one part of an overall evaluation of prostate health.
Who should be screened?
PSA testing is crucial for men with a family history of prostate cancer. Also, African American men have a higher incidence of prostate cancer. In both cases, initial PSA screening has been recommended starting at that age of 40. For all other men, PSA screening is recommended by the age of 50. The American Urological Society has stated that men between the ages of 55 and 69 benefit most from PSA screening. Today, the average age of men being diagnosed with prostate cancer is 66.
Men diagnosed with prostate cancer have their PSA levels routinely screened to assess progression of the disease. This is particularly useful for men who have chosen ‘watchful waiting’ rather than immediate treatment. For those who have undergone treatment, as well as those who are in remission, regular PSA testing is recommended to closely monitor their prostate health.
PSA testing is a decision made between the patient and their provider. If you would like an evaluation of your prostate health, contact our office to schedule an appointment.
American Urological Association – Early Detection of Prostate Cancer
Prostate Cancer Watchful Waiting