Prostate Cancer Screening

Topic Overview

Screening for prostate cancer—checking for signs of the disease when there are no symptoms—is done with the digital rectal exam and the prostate-specific antigen (PSA) test. In the United States, about 75% of men who are age 50 or older have had a PSA test.1

The number of deaths caused by prostate cancer has dropped over the past 20 years. The decrease has been linked to more cases of early diagnosis through PSA testing and to better cancer treatment.2

Finding prostate cancer early leads you to some big decisions. Most prostate cancer grows slowly. And the side effects of treatment can change your quality of life—mainly not being able to have an erection (impotence) and not being able to control urination (incontinence). If you are around age 70 or older, these side effects may seem worse than early-stage cancer that may not grow much during your lifetime. But, especially for men 65 or younger, treatment makes the cancer less likely to grow and spread.3

So before you decide to have a PSA test, talk with your doctor. Ask about your risk for prostate cancer, and discuss the pros and cons of testing. Some men will not want to live with the side effects of treatment. Other men are more concerned about survival. It is important to learn all you can and talk to your doctor before making a decision.

Click here to view a Decision Point. Should I have a PSA test to screen for prostate cancer?

After reviewing research on routine screening for prostate cancer using the PSA test, the U.S. Preventive Services Task Force (USPSTF) recommends the following:4

  • Men age 75 and older should not be screened for prostate cancer.
  • Men younger than 75 should talk with a doctor about the pros and cons of PSA testing before being tested. Men younger than 75 with long-term medical problems or who are expected to live less than 10 years are unlikely to benefit from screening.

For more information, see the topic Prostate Cancer.

References

Citations

  1. Punglia RS, et al. (2003). Effect of verification bias on screening for prostate cancer by measurement of prostate-specific antigen. New England Journal of Medicine, 349(4): 335–342.
  2. American Cancer Society (2006). Cancer Facts and Figures 2006, pp. 1–56. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/STT/stt_0.asp.
  3. Bill–Axelson A, et al. (2005). Radical prostatectomy versus watchful waiting in early prostate cancer. New England Journal of Medicine, 352(19): 1977–1984.
  4. Lin K, et al. (2008). Benefits and harms of prostate-specific antigen screening for prostate cancer: An evidence update for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 149(3): 192-199.

Credits

Author Debby Golonka, MPH
Editor Susan Van Houten, RN, BSN
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Last Updated August 28, 2009

Last Updated: August 28, 2009

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