As mentioned in previous articles, prostate specific antigen which is also known as PSA may tell you something about your prostate cancer risk.
Let’s talk about when you should consider checking your PSA levels, depending on different risk factors.
When should you check your PSA levels?
Here are some guidelines on when you should check your PSA levels:
Under age 40: PSA screening is not recommended.
Aged 40-54: Routine PSA screening is not recommended.
Under age 55 at high risk: (family history or you are black African and Afro-Caribbean): The decision for screening should be individualized.
Aged 55-69: Talk to your health care provider about the benefits and risks of prostate cancer testing.
Aged 70 plus: Routine PSA screening is not recommended But men over 70 should talk to their health care provider about prostate cancer testing if they have any concerns.
Source: American Urology Association
PSA stands for prostate-specific antigen, a substance produced in the prostate. PSA levels are determined through a blood test. Elevated PSA levels may suggest the presence of prostate cancer. The test is not, however, prostate cancer specific.
It is essential that those who are thinking about prostate cancer screening are aware that the full screening involves a rectal examination by a physician who will evaluate the feel and texture of the prostate gland as well as a blood test that measures prostate specific antigen.
I often talk to my patients about the known limitations of PSA testing, particularly the fact that it is not cancer specific.
However, as prostate cancer is the most common cancer, and the number two cancer killer, of men, it is important to talk to your doctor if you have any symptoms of prostate cancer as well as to understand , PSA screening generally, and the shortcomings of the test.
In sum, if you are thinking about attending prostate cancer screening, you must:
- Take a PSA test which will measure prostate specific antigen in the blood.
- Attend a rectal examination.
I counsel my patients based on a lot of the position papers and best practice recommendations from the American Urological Association so you know the best answer to that question is if there is no family history for the disease if you're not of African descent, then probably, baseline PSA blood test and rectal exam at about age 50 is a good starting point. That screening is going to be a PSA test and a rectal exam.
Both are important, I want to make that point very clear.
I know men don't want to run in and have a rectal exam but it really is not just enough to have a blood test. It's just not enough to have the rectal exam either. You really need both of these and we assume that's all at that initial stage.
If you've got a family history of the disease, such as a first degree relative, if you're of African descent, talk to your doctor about moving the timeframe for prostate cancer forward and determine together whether that makes sense for you.
Why should you check your PSA levels?
You should consider early screening for prostate cancer because the prevalence of prostate cancer is on the rise.
For prostate cancer, the most typical age of diagnosis is when a man is in his mid-sixties. It’s very unusual to ever see it before the age of 40 unless there a man is at high risk for prostate cancer.
Regardless, we know that for each decade a man lives, the chance of getting prostate cancer goes up.
According to the American Cancer Society, at least 1 in 9 men in the United States will be diagnosed with prostate cancer which works out mathematically to about 175,000 new diagnoses per year in the U.S. right now. A little over 30,000 men will die from prostate cancer this year in the United States. Prostate cancer is second only to lung cancer as the leading cause of cancer death in men, in the United States.
Early detection is key in receiving appropriate and timely treatment. For men who choose to use PSA testing as their chosen method, the volume of PSA vs. the testing range varies. According to the Mayo Clinic, men with a PSA volume of less than 2.5ng/ml may need to be retested every two years, for men with a reading of over 2.5ng/ml, they should get tested each year.
Men who take a PSA test should bear in mind that they also may need a digital rectal exam (DRE) as part of their screening.
The PSA test can offer insight into whether further testing should be pursued following early onset symptoms and
LetsGetChecked offer support and advice at every step of the way regarding your test results.
You should consider taking a PSA test if:
- You are over the age of 50
- You have a strong family history of prostate cancer
- You are experiencing symptoms related to prostate cancer
- You are overweight or obese
Written by Dr. Robert Mordkin | Edited by Hannah Kingston