Should You Have a PSA Blood Test? - Crozer-Keystone Health System - PA

Published on October 07, 2015

Should You Have a PSA Blood Test?

A prostate-specific antigen (PSA) test can be
among the best ways to prevent prostate cancer.

Prostate cancer is one of the most common cancers in American men. About one in seven men will be diagnosed with this form of cancer in his lifetime.

Unfortunately, there’s no sure way to prevent prostate cancer. Because of that, the best things you can do are to understand your risk factors for disease and regularly see your doctor for prostate cancer screenings.

One of those screenings is the prostate-specific antigen (PSA) test, which can determine if a man has prostate cancer and how advanced it is.

What Is a PSA Test?

The way this test works is that it measures the amount of PSA is in your blood. PSA is a protein produced in the prostate. Small amounts of PSA typically circulated in the blood. But if a PSA test detects high levels of PSA in your blood, it may indicate the presence of prostate cancer.

But there’s been recent controversy surrounding the PSA test.

First, there’s the potential for the test to yield false positive results – elevated levels of PSA could be caused by something other than cancer. A high PSA level can be caused by any type of prostate infection or prostate enlargement, which is common in men after the age of 50. Even ejaculation within two days of having a PSA test may result in artificially high levels suggesting a "false positive." Also, PSA levels normally increase with age.

False-positive test results can trigger anxiety and lead to additional procedures, including prostate biopsy, which pose the risk of side effects.

Additionally, sometimes there are false-negative results, in which PSA levels are normal but aggressive prostate cancer is missed. These results may give a man, his family and doctor false assurance.

A third issue that has been raised is that the PSA test can help detect small tumors that don’t cause symptoms and may not be life threatening. This can lead to over -diagnosis and overtreatment. Overtreatment can expose men to potential complications and treatment side effects.

It’s not all that bad though – a PSA test may help detect prostate cancer when it’s in an early stage when it’s easier to treat and more likely to be cured with treatment.

Should You Get a PSA Test or Not?

That’s a question you should discuss with your doctor, who can help you weigh the benefits and the risks of the test. Your doctor can help you make the decision based on your age, risk factors and life expectancy.

If you have a family history of prostate cancer, you should aim to have this conversation about screening at an earlier age.

In addition to a PSA test, a digital rectal exam can be performed on a regular basis to help your doctor detect any abnormalities in the prostate’s texture, shape or size.

In addition to screening methods, men can follow a healthy lifestyle to manage their risk of prostate cancer. That includes exercising regularly, losing excess weight, eating more fruits and vegetables, reducing the fat in your diet, and quitting smoking.

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