Prostate Cancer Screening

What is cancer screening?

Cancer is a disease when the cells of the body grow out of control. Cancer screening is having tests to look for signs of cancer before you have any symptoms. By the time cancer causes symptoms, it may have already spread to other parts of your body. A screening test may help find cancer early, when it may be easier to treat.

Cancer screening only tells you whether you might have cancer. It doesn't diagnose cancer. If a screening test shows signs of cancer, you'll need to have other tests to find out if you do have cancer and how serious it may be.

What is prostate cancer screening?

Prostate cancer screening looks for signs of cancer in the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

Prostate cancer is most common in people over age 50. It usually grows slowly and doesn't cause health problems. In fact, it's possible to live a long life with prostate cancer and never know you have it. But in certain cases, prostate cancer may spread to other parts of the body and can be very serious.

The goal of prostate cancer screening is to find prostate cancers that may be more likely to spread so they can be treated early.

What tests screen for prostate cancer?

Two tests are commonly used to screen for prostate cancer:

• A prostate-specific antigen test, also called a PSA blood test. PSA is a protein made by your prostate. A high level of PSA in your blood may mean you have prostate cancer, but it's not proof of cancer. That's because many other things may cause high PSA levels, including:
  
  
  • Having an enlarged prostate (benign prostatic hyperplasia or BPH)
  • Having other common prostate problems
  • Taking certain medicines
  
  In general, the higher your PSA, the more likely it is that you have cancer. But a low PSA blood level isn't a guarantee that you don't have cancer.
  
  
• Digital Rectal Examination (DRE). The DRE is a prostate exam. In this exam, your health care provider inserts a lubricated, gloved finger into your rectum to feel your prostate for lumps or anything unusual. A DRE can check only one side of the prostate.

A PSA test or a DRE may be able to detect prostate cancer at an early stage. But it is not clear whether early detection and treatment lower the risk of dying from prostate cancer. You should talk with your provider about the benefits and harms of prostate cancer screening.

What are the possible benefits and harms of prostate cancer screening?

The possible benefits of prostate cancer screening include:

• Finding and treating prostate cancer early before it spreads
• Getting a better sense of your prostate cancer risk (based on your PSA test)
• Peace of mind if your screening shows you're unlikely to have prostate cancer now
• The option to choose further testing and closely monitor your prostate if your screening shows you may have cancer

The possible harms of prostate cancer screening include:

• Getting a false positive result. This means that your PSA test shows you may have prostate cancer when you really don't. A false positive may lead to:
  
  
  • Worry while you have more tests to look for signs of cancer.
  • A prostate biopsy. In a biopsy, a doctor removes tissue from your prostate so it can be studied under a microscope to look for cancer cells. This is the only way to diagnose cancer. The possible harms of a prostate biopsy include:
    • Fever
    • Pain
    • Blood in semen
    • Urinary tract infection
  
  
• Having prostate cancer treatment that you may not have needed. Prostate cancer screening may lead to a cancer diagnosis, but it's not always clear whether the cancer is likely to grow and spread. You could have unnecessary treatment for cancer that would never have caused any health problems. And the common prostate cancer treatments may have serious, permanent complications, such as:
  
  
  • Urinary incontinence
  • Erectile dysfunction
  • Problems controlling your bowel movements (BMs)

Should I be screened for prostate cancer?

Since there are benefits and risks to prostate screening, you should talk with your provider to decide if screening is right for you. You and your provider should consider:

• Your age. The risk of prostate cancer increases after age 50.
• Your family health history. If members of your family have had prostate cancer, your risk may be higher.
• Your race. Prostate cancer is more common in African Americans. They also have a higher risk of developing prostate cancer at a younger age and having more serious disease.
• Your general health. Are you well enough to have treatment for prostate cancer if it's found?
• What you prefer. How do you feel about the possible benefits and harms of screening, diagnosis, and treatment?

NIH: National Cancer Institute