Prostate Cancer Screening

Topic Overview

Screening for prostate cancer—checking for signs of the disease when there are no symptoms—is done with the prostate-specific antigen (PSA) test. About 21,000 men are diagnosed with prostate cancer in Canada every year.footnote 1 In the United States, about 12 out of 100 men in the U.S. will be diagnosed with prostate cancer sometime in their lifetime.footnote 3 But most men who are diagnosed with prostate cancer don't die from prostate cancer.

Finding prostate cancer early leads you to some big decisions. Most prostate cancer grows slowly. And the side effects of treatment may change your quality of life. It's possible that you may not being able to have an erection or control urination after surgery. If you are older with other serious health problems, these side effects may seem worse than early-stage cancer that may not grow much during your lifetime. But for active or younger men, treatment may help them live longer.

So before you decide to have a PSA test, talk with your doctor. Ask about your risk for prostate cancer, and discuss the pros and cons of testing. Some men will not want to live with the side effects of treatment. Other men are more concerned about survival. It is important to learn all you can and talk to your doctor before making a decision.

Prostate Cancer Screening: Should I Have a PSA Test?

After reviewing research on routine screening for prostate cancer, the Canadian Cancer Society recommends that all men older than age 50 discuss with their doctor the potential benefits and risks of early detection methods. Men with a family history of prostate cancer or of African ancestry may wish to discuss the need for testing at a younger age.footnote 2

Other expert groups, such as the American Cancer Society (ACS) and the American Urological Association (AUA), disagree.

  • The American Cancer Society (ACS) advises men to talk with their doctors about testing and treatment before deciding about testing. The ACS says that men should not be tested without learning about the risks and benefits. The ACS advises talking to a doctor about testing:
    • At age 50 for men who are at average risk of getting prostate cancer and are expected to live at least 10 more years.
    • At age 45 for men at high risk, such as African Americans and men who have a first-degree relative (father, brother, or son) who had prostate cancer when he was younger than 65.
    • At age 40 for men at an even higher risk, such as those with several first-degree relatives who had prostate cancer at an early age.
    • Men who decide to have this test may only need to be retested every 2 years if their PSA is less than 2.5 ng/ml. But testing should be done yearly for men whose PSA is 2.5 ng/ml or higher.
  • The American Urological Association (AUA) recommends that:
    • Men under age 40 shouldn't have PSA screening.
    • Men ages 40 to 54 who are at average risk shouldn't have routine PSA screening.
    • Men ages 55 to 69 should talk with their doctors about having the test. Discuss the benefits and harms of PSA screening before deciding if you want the test. If you decide to have this test, having it every 2 years rather than every year may reduce the harms.
    • Men ages 70 and older (or any man with less than a 10- to 15-year life expectancy) shouldn't have routine PSA screening.

For more information, see the topic Prostate Cancer.

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References

Citations

  1. Canadian Cancer Society's Advisory Committee on Cancer Statistics (2017). Canadian Cancer Statistics 2017. Toronto, ON: Canadian Cancer Society. Available online: http://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20cancer%20statistics/Canadian-Cancer-Statistics-2017-EN.pdf?la=en.
  2. Canadian Cancer Society (2007). Prostate cancer: Can it be prevented? Available online: http://www.cancer.ca/Canada-wide/Publications/Alphabetical%20list%20of%20publications/Prostate%20cancer%20How%20to%20reduce%20your%20risk.aspx?sc_lang=en.
  3. National Cancer Institute (2017). SEER cancer stat facts: Prostate cancer. National Cancer Institute. http://www.seer.cancer.gov/statfacts/html/prost.html. Accessed July 10, 2017.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Brian D. O'Brien, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology, Oncology

Current as ofMarch 6, 2018

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