The prostate-specific antigen (PSA) test is a common screening method for prostate cancer. It measures the levels of PSA, a protein produced by the prostate gland, in a man’s blood.

Elevated PSA levels may indicate the presence of prostate cancer or other prostate conditions. But when should you have your PSA test for prostate cancer? The answer is not straightforward.

What Is Prostate Cancer?

Prostate cancer is a type of cancer that starts in the prostate gland. The prostate is a small gland located below the bladder and in front of the rectum in men. It produces the fluid that nourishes and transports sperm.

Prostate cancer usually grows slowly and initially stays within the prostate gland, where it may not cause serious harm. However, some types of prostate cancer can grow quickly and spread to other parts of the body.

Who Is at Risk of Prostate Cancer?

Prostate cancer mainly affects men over 50 years old. The risk of prostate cancer increases with age, family history of the disease, African-American ethnicity, and certain genetic mutations.

Other risk factors include obesity, smoking, lack of exercise, and a diet high in fat and red meat. However, some men with none of these risk factors can still develop prostate cancer.

What Is the PSA Test and How Does It Work?

The PSA test is a blood test that measures the levels of PSA in a man’s blood. PSA is a protein produced by the prostate gland that helps semen liquefy and aids sperm motility.

Some PSA is normal, but higher levels may indicate the presence of prostate cancer or other prostate conditions such as prostatitis (inflammation of the prostate gland) or benign prostatic hyperplasia (enlargement of the prostate gland). However, a high PSA level does not always mean that a man has prostate cancer, and a normal PSA level does not always rule out the presence of prostate cancer.

What Are the Pros and Cons of PSA Testing?

The PSA test is a controversial screening method for prostate cancer because it has both pros and cons.

: Pros

The PSA test is simple and non-invasive. It involves only a blood sample.
The PSA test is widely available and relatively inexpensive.
The PSA test can detect prostate cancer early, when it is more treatable.

: Cons

The PSA test is not specific for prostate cancer. A high PSA level can be caused by other prostate conditions that may not require treatment.
The PSA test can lead to overdiagnosis and overtreatment of prostate cancer, which can cause harm and unnecessary cost.
The PSA test can cause anxiety, stress, and harm to men who undergo unnecessary biopsies, treatments, and side effects.

When Should You Have Your First PSA Test?

The American Cancer Society recommends that men discuss the pros and cons of PSA testing with their healthcare providers and make an informed decision based on their individual preferences and risk factors.

The decision to have a PSA test should not be based on age alone. The age at which men should start having PSA testing depends on their individual risk factors and values.

For men at average risk of prostate cancer, the American Cancer Society suggests:.

Men who are 50 years old or older should talk to their healthcare providers about the pros and cons of PSA testing.
Men who are African-American or have a family history of prostate cancer should talk to their healthcare providers about the pros and cons of PSA testing starting at age 45.
Men with certain genetic mutations associated with prostate cancer should talk to their healthcare providers about the pros and cons of PSA testing at a younger age.

Should You Have Routine PSA Testing?

Whether men should have routine PSA testing (i.e., screening at regular intervals) or one-time PSA testing depends on their individual risk factors and values.

The American Cancer Society suggests that men who decide to have PSA testing should follow these guidelines:.

Men who have a PSA level of less than 2.5 ng/mL may only need to have PSA testing every two years.
Men who have a PSA level of 2.5 ng/mL or higher should have PSA testing every year to monitor changes in PSA levels and the risk of prostate cancer.
Men who have an abnormal PSA level or other prostate symptoms may need further testing, such as a prostate biopsy, imaging studies, or a referral to a urologist or other specialist.

What Are Some Other Ways to Reduce the Risk of Prostate Cancer?

While PSA testing can detect prostate cancer early, it does not prevent prostate cancer. Therefore, men can take other steps to reduce their risk of prostate cancer, such as:.

Eating a healthy diet that is low in fat and red meat and high in fruits and vegetables.
Exercising regularly and maintaining a healthy weight.
Not smoking or quitting smoking if they do smoke.
Seeing their healthcare providers regularly and getting recommended screenings for other medical conditions.

Conclusion

The decision to have a PSA test for prostate cancer should be based on individual risk factors and values. Men should discuss the pros and cons of PSA testing with their healthcare providers and make an informed decision that is right for them.

While PSA testing can detect prostate cancer early, it also has limitations and potential harms. Therefore, men can take other steps to reduce their risk of prostate cancer, such as leading a healthy lifestyle and seeing their healthcare providers regularly.