Prostate Cancer Screening

Prostate Cancer Screening Guidelines

Although prostate cancer is serious, it’s very treatable when detected early. Most men who have early prostate cancer don’t experience symptoms, therefore it's important that you discuss with your doctor whether prostate screening is right for you – based on your age, health status and family history.

Prostate Cancer Screening Methods

There are two common types of prostate cancer screenings - the prostate-specific antigen test (PSA) and the digital rectal exam (DRE). Neither the PSA test nor a DRE provides conclusive proof of problems, including cancer, and there are differing opinions about when these tests should be used as well.

Prostate-Specific Antigen (PSA) Test

A PSA test is a blood test that measures the level of PSA in a man’s blood. PSA is a protein produced by the cells of the prostate. Healthy men have low amounts of PSA in the blood. An elevated PSA may indicate an enlarged prostate or be caused by inflammation of the prostate gland or prostate cancer.

Your chance of developing prostate cancer increases as your PSA level increases. 4 ng/mL is a common threshold for determining whether a man needs further testing. Checkups that measure your ng/mL level will help your Mercy doctor decide if you need more tests to determine a prostate cancer diagnosis.

Digital Rectal Exam (DRE)

A DRE is a common test for most physicians to determine a patient’s risk of prostate cancer. Your Mercy doctor will insert a gloved hand into your rectum, feeling the back wall for any prostate gland enlargement, lumps or tenderness. A DRE is often done together with a simple PSA check. If irregularities are found, a biopsy is needed to confirm any findings.

A digital rectal exam is performed by a doctor or nurse who manually checks for abnormalities by inserting a gloved, lubricated finger in the rectum to determine, based on feel, if the prostate is:

• Normal size and has a smooth surface
• Larger than expected for your age – this could be a sign of an enlarged prostate
• Hard and lumpy – this could be a sign of prostate cancer

Prostate Cancer Screening Recommendations

• The American Urologic Association recommends discussing PSA screening with your doctor between the ages of 55 and 59. 
• Screening is not recommended in low-risk men younger than 55 or older than 70.
• However, risk factors, such as a family history of prostate cancer and African-American race, should be considered when deciding the age to start screening.

As needed, both tests are normally performed by your primary care physician. If problems are suspected, your doctor may refer you to a urology or cancer specialist.