A Guide to Prostate Cancer Screening

Methods of Screening

There are two main components to prostate cancer screening:

1. PSA (Prostate-Specific Antigen) Blood Test

This is a simple blood test that measures the level of PSA, a protein produced by the prostate gland. Higher levels of PSA can be an indicator of prostate cancer, but they can also be caused by other non-cancerous conditions, such as:

• Benign Prostatic Hyperplasia (BPH): An enlarged prostate.
• Prostatitis: Inflammation or infection of the prostate.
• Recent Ejaculation: It's recommended to avoid ejaculation for 48 hours before the test.

Because of this, an elevated PSA is not a diagnosis of cancer, but rather a sign that more investigation may be needed. The trend of your PSA level over time (PSA velocity) is often more important than a single reading.

2. Digital Rectal Exam (DRE)

During a DRE, a doctor inserts a gloved, lubricated finger into the rectum to feel the back wall of the prostate gland. They can check for any hard lumps, nodules, or abnormalities in the shape or size of the prostate. While it can be slightly uncomfortable, it is a quick and valuable part of the examination.

When Should You Start Screening?

The recommendations for when to start screening are based on your level of risk:

• Average Risk: For most men, the discussion about screening should begin around age 50.
• High Risk: Men with a close relative (father, brother, son) diagnosed with prostate cancer before age 65 should start the discussion earlier, around age 40-45.

Interpreting Results

If your PSA is elevated or a DRE is abnormal, it does not mean you have cancer. Your doctor will discuss the results with you and may recommend repeating the test, further imaging (like an MRI), or a referral to a urologist for a biopsy to get a definitive diagnosis.