Prostate Specific Antigen Screening

What is prostate specific antigen?

Prostate specific antigen (PSA) is an enzyme made by the prostate gland. The prostate gland is a doughnut-shaped gland located in the small space between the base of the penis and the bladder. The prostate makes the fluid that nourishes sperm and carries sperm during ejaculation.

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 can 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. It is not clear whether it should be done routinely. Like many cancer screening tools, the test is not perfect and can give misleading results. If the result is normal, there may still be cancer in the prostate. If 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 causes other than the cancer. The current recommendations are that men age 75 and older should not 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 have prostate cancer, it 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), 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/.