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
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.
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.