Prostate cancer is the most common non-skin cancer in men in the United States, and it is the second leading
cause of cancer death in men. One in six men will be diagnosed with prostate cancer during his lifetime. African-American
men face a one in three chance of being diagnosed. Over 30,000 men die each year from prostate
cancer; however, early detection saves lives.
For many years, prostate-specific antigen
(PSA) testing has been the most widely available test to identify changes in the prostate. PSA is a substance produced by
the prostate gland. The PSA level in a man's blood is an important marker of many prostate diseases, including prostate cancer.Although the U.S. Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA)-based
testing for prostate cancer their recommendation was largely based on flawed and poorly designed studies. The
ERSPC being the best and largest prostate screening study showed a large benefit for screening. To view article. CLICK HERE.
The American Urological Association (AUA) and its Foundation are
concerned that the USPSTF recommendations may present conflicting and confusing information to patients about the value of
this critical prostate-cancer screening test. The AUA strongly opposes the task force's position
and believes that, for most men, the benefits of prostate cancer early detection should not be discounted.
INFORMED DECISION MAKING
While the AUA and its Foundation are aware of the limitations of PSA testing, we also understand that, when results are interpreted
appropriately, the test provides important information in the diagnosis, pre-treatment staging or risk assessment and monitoring
of prostate cancer patients.
The decision to get tested is one that
a man should make with his doctor following a careful discussion. This conversation should include not only
the benefits and risks of screening, but a man's personal and family medical history. For men who wish to be screened, the
AUA recommends getting a baseline PSA, along with a physical exam of the prostate known as a digital rectal exam (DRE) at
age 40. Evidence from research studies suggests that combining PSA and DRE improves the overall
rate of prostate cancer detection.
Men choosing to undergo PSA
testing should remember these important factors about the test results:
- Three common
prostate diseases- prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer-can all cause elevated PSA levels
in the blood.
- PSA levels tend to increase with age.
- Larger prostates produce larger amounts of PSA.
- Medications, trauma or
certain medical procedures (such as a prostate biopsy or cystoscopy) can affect PSA test results.
- Change in PSA levels over time, known as PSA velocity, is used to assess both cancer risk and aggressiveness. Men
whose PSA levels rise sharply over a short period are more likely to have prostate cancer than those who do not see significant
changes in their PSA velocity.
PSA: NEXT STEPS
If your physician has concerns about your PSA or DRE results, he or she may recommend a biopsy. A prostate biopsy is the only
way to confirm the presence of prostate cancer.
While the decision to proceed with a prostate
biopsy may be prompted by PSA and DRE results, this decision should also take into account other factors including a man’s
family history of prostate cancer, his race, any prior biopsy history and other significant health issues he may have.
To learn more about prostate cancer, visit KnowYourStats.org and click on the Resources link. UrologyHealth.org also includes valuable patient education information about prostate cancer,
as well as many other urologic health resources and research information.