Prostate Cancer Screening in Mountlake Terrace, Washington (WA)

Prostate cancer is one of the most common cancers in men. Early detection can save your life by catching the cancer in its early, most treatable stages. The two tests most often used for prostate screening are a digital rectal exam, and a prostate specific antigen (PSA) test.

A digital rectal exam is a physical exam performed by your doctor while wearing lubricated gloves. Your doctor will use a lubricated finger (a “digit”) to check your prostate for any changes in size, shape or texture.

Prostate specific antigen (PSA) test is a blood test used to check PSA levels in the blood. PSA is a protein produced by the prostate. High levels of PSA may indicate prostate cancer.

Because high PSA levels can also indicate other conditions such as prostatitis (inflammation of the prostate), PSA testing has led to a high number of false positives and some unnecessary biopsies. Nevertheless, PSA remains a routine and effective screening tool for prostate cancer.

In addition to being a helpful prostate cancer screening tool, the results of a PSA test can also measure the effectiveness of prostate cancer treatment.

Who Should Be Screened?

Organizations such as the American Urological Association (AUA) and the American Cancer Society and others differ on their recommendations as to whom should be screened. Ultimately the decision is made between a man and his doctor, based on his risk factors individual preferences. Due to the risks inherent in PSA screening including a high number of false positives, the American Urological Association (AUA) provides the following recommendations for men:

40 years and younger: AUA recommends against screening as there is a low prevalence of prostate cancer, and no evidence that screening is beneficial, though risks do exist.

40 to 54 years: For men in this age group who are of average risk, AUA does not recommend routine screening, but also doesn't recommend against it. For men 40-54 years old, who do have a risk factor for prostate cancer, AUA recommends making the decision to screen on an individual basis with your doctor.

55 to 69 years: As this group can benefit the most from PSA testing, AUA recommends shared-decision making between you and your doctor, to weight the benefits of preventing prostate cancer mortality (1 man for every 1,000 screened), against the harms and in alignment with your own values and preferences.

70 years and older: AUA does not recommend PSA testing for this group or for anyone with a life expectancy less than 10 to 15 years.

Though the PSA test itself is simple, the decision whether to have one can be complicated. Talk to your doctor about whether a PSA screening is right for you.

Risks of PSA Testing

The test itself poses no real risks. However, risks include: false-positives and the resulting heightened anxiety, false-negatives leading to a misdiagnosis of aggressive prostate cancer, stress and anxiety from knowing one has a slow-growing cancer that does not need treatment, and finally, the decision to undergo a treatment that is expensive and also more harmful than untreated prostate cancer.

Talk to your doctor about whether prostate cancer screening is right for you.