PSA Screening

What is PSA?

PSA is the abbreviation for prostate specific antigen, which is an enzyme made by the prostate gland. The prostate gland is part of a man's reproductive system. It is, on average, a little bigger than a walnut. It surrounds the upper part of the urethra below the bladder. (The urethra carries urine from the bladder out through the penis.) The prostate makes the fluid that nourishes and carries sperm.

PSA is found in a man’s blood and can be measured with a simple blood test. The prostate usually makes more PSA if you have prostate cancer. Checking the amount of PSA made by the prostate gland may help find prostate cancer very early. A PSA test is also a way to check how well treatment of prostate cancer is working.

The risk of prostate cancer gets higher with age. It has become the most commonly diagnosed cancer in men in the US. It is the second leading cause of cancer deaths of men in the US. The prostate cancer death rate is especially high among African American men.

How is the test used?

The PSA test shows whether the amount of PSA in the blood is in the normal range.

The value of the PSA blood test is not certain. A national medical practice advisory committee called the US Preventive Services Task Force does not recommend routine PSA screening for all men. Like many cancer screening tools, the test is not perfect and can give misleading results. A normal result does not necessarily mean that there is no cancer in the prostate. If the result is a bit high, it may not be from cancer, but the abnormal result may cause anxiety, expense, and unnecessary medical procedures. Also, prostate cancer usually grows slowly. Men who have it are more likely to die from something other than prostate cancer. The current recommendation is that men age 75 and older do not need to be screened for prostate cancer. Men younger than 75 should discuss the benefits and harms of the PSA test with their healthcare provider before being tested.

What are the advantages of PSA screening?

The advantages of the PSA test are:

• It can be done with a simple blood test.
• It is less expensive than other tests, such as ultrasound scans.
• It helps detect small cancers that cannot be found with a physical exam.
• If you are being treated for prostate cancer, the test can be used to help see how well your treatment is working.
• It can be used to look for the return of prostate cancer after treatment.

What are the disadvantages of PSA screening?

The disadvantages of the PSA test are:

• It does not always detect prostate cancer. The results of the test are in the normal range in 25% to 45% of men with prostate cancer.
• Other prostate conditions, namely prostate infection and prostate enlargement (benign prostatic hyperplasia, or BPH), can also increase the PSA level.

Talk to your healthcare provider about the test. For more information, you can call the American Urological Association Foundation (AFUD) at 800-828-7866 or visit their Web site at http://www.urologyhealth.org/.