Prostate cancer can be successfully treated if detected early. To increase the chances of early detection, healthcare providers recommend routine screening, ideally before any symptoms present. Screening usually begins with a physical examination, which may be followed by blood tests, urine tests, or a biopsy if the doctor observes any irregularities.

Candidates for Screening

Prostate cancer affects 1 out of 8 men. Age, genetics, and racial background are factors that can determine who should be screened. Men diagnosed with prostate cancer are likely to be older. Having a family member diagnosed with prostate cancer increases your risk. Statistically, African-American men are more likely to develop prostate cancer than Caucasian men.  

Digital Rectal Exam

Routine screening may begin with a manual examination of the prostate gland. The healthcare provider inserts a gloved finger into the rectum to inspect the prostate, located in front of the rectum and behind the bladder. Abnormalities such as firm areas, bumps, or nodules indicate that further testing is needed to determine if cancer is present.

Prostate Specific Antigen

Cells in the prostate gland produce a protein called prostate-specific antigen, or PSA. PSA can be detected in a blood sample, measured in nanograms/liter (ng/l.) Results under 4 ng/l indicate that the risk of prostate cancer is low. A result between 4-10 ng/l means there is a 25 percent chance of developing prostate cancer. Greater than 10 ng/l correlates to a 50 percent chance of cancer. 

Prostate Cancer Urine Test

Another type of screening test can detect the PCA3 gene in a urine sample. The PCA3 gene occurs only in the prostate. If the gene makes too many copies of itself, it may indicate that prostate cancer can develop. Eighty percent of patients with prostate cancer have a positive PCA3 test. 

Prostate Biopsy

If other screening tests indicate a high risk of prostate cancer, a biopsy may be needed to confirm the diagnosis. An MRI may be performed prior to the biopsy to identify areas of the prostate that appear irregular. The doctor uses needles to extract tissue samples from different areas of the gland. Ultrasound may be used during the biopsy to aid the doctor in needle placement.

Risks Associated with Prostate Screening

False positives and false negatives can result from screening tests. PSA levels may be elevated due to infection, enlargement of the prostate, bicycling, or recent ejaculation rather than cancer. Medications and herbal supplements can lower PSA, even if cancer is present. A biopsy can cause complications such as infection, UTI, pain, and blood in urine or semen.

To learn more about prostate cancer testing, contact a healthcare clinic in your area.