The purpose of screening is early diagnosis and treatment. Screening tests are administered to people who may be at high risk for certain diseases or conditions, but do not have any symptoms.

Screening Guidelines

Using the PSA test as a screening tool is a controversial topic. The US Preventative Services Task Force (USPSTF) and the American Academy of Family Physicians do not recommend this test due to the potential harms outweighing the benefits. The American Cancer Society (ACS) recommends that men talk to their doctors about the benefits and risks of the PSA test. The USPSTF also points out the importance of discussing this screening test with your doctor.

The PSA test measures the levels of PSA in your blood. PSA is a chemical produced in the prostate gland and released into the bloodstream. Prostate cancer, with its overabundance of rapidly dividing prostate cells, tends to increase PSA levels. An elevation in PSA levels may also occur as a result of:

  • Prostate enlargement—benign prostatic hyperplasia
  • Inflammation of the prostate—prostatitis
  • Ejaculation—Your doctor may ask you to abstain from sexual activity for 2 days before the test
  • If your PSA is elevated, it does not necessarily mean you have cancer. Depending on your PSA level, physical exam, and risk factors, your doctor may suggest other options, such as:

  • Repeating the test at a later date
  • Ordering other tests
  • Doing a biopsy of the prostate gland to determine if cancer is present
  • A digital rectal exam may be done as part of a normal physical exam, but it is not considered a screening test. The doctor inserts one gloved and lubricated finger into the rectum and feels the contours of your prostate through the rectal wall. If there is a tumor in the prostate gland and it is large enough, the doctor may be able to feel it. However, some cancers may be so small that they cannot be felt during this exam.