Complications (1)
- Obesity
Prevention (1)
- Prostate cancer prevention: What you can do
Symptoms (2)
- Urinary incontinence
- Symptom Checker
Tests and diagnosis (5)
- Biopsy: Types of biopsy procedures used to diagnose cancer
- Prostate cancer screening: Should you get a PSA test?
- Needle biopsy
- see all in Tests and diagnosis
Treatments and drugs (6)
- External beam radiation therapy for prostate cancer
- Surgery: Radical prostatectomy
- Cryotherapy for prostate cancer
- see all in Treatments and drugs
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Prostate cancer screening: Should you get a PSA test?
Making the decision to have a PSA test depends on a variety of factors. Here are some tips that will help you make a good decision.
By Mayo Clinic staffCancer screening tests — including PSA tests to look for signs of prostate cancer — can be a good idea. They can help identify cancer early on, when treatment is most effective. A normal PSA test, combined with a digital rectal exam, can help reassure you that it's unlikely you have prostate cancer. But, getting a PSA test for prostate cancer may not be necessary for some men, especially men 75 and older.
Professional organizations vary in their recommendations about who should — and who shouldn't — get a PSA screening test. While some have definitive guidelines, others leave the decision up to men and their doctors. The organizations that do make recommendations generally encourage PSA testing in men between the ages of 40 and 75, and in men with an increased risk of prostate cancer. Ultimately, whether you should have a PSA test is something you'll have to decide after discussing it with your doctor, considering your risk factors and weighing your personal preferences.
What is a PSA test?
Prostate-specific antigen (PSA) is a protein produced by both cancerous (malignant) and noncancerous (benign) prostate tissue. PSA helps liquefy the semen. A small amount enters the bloodstream. Cancer cells usually make more PSA than do benign cells, causing PSA levels in your blood to rise. However, determining what a high PSA score means can be complicated. Besides the PSA number itself, your doctor will consider a number of other factors to evaluate your PSA scores:
- Your age
- The size of your prostate gland
- How quickly your PSA levels are changing
- Whether you're taking medications that affect PSA measurements, such as finasteride (Propecia, Proscar), dutasteride (Avodart) and even some herbal supplements
When elevated PSA isn't cancer
While high PSA levels can be a sign of prostate cancer, a number of conditions other than prostate cancer also can cause PSA levels to rise. These other conditions could cause what's known as a "false-positive" — meaning a result that falsely indicates you might have prostate cancer when you don't. Conditions that could lead to an elevated PSA level in men who don't have prostate cancer include:
- Benign prostate enlargement (benign prostatic hyperplasia)
- A prostate infection (prostatitis)
- Other less common conditions
False-positives are common. Only about one in four men who have a positive PSA test turns out to have prostate cancer.
When prostate cancer doesn't increase PSA
Some prostate cancers, particularly those that grow quickly, may not produce much PSA. In this case, you might have what's known as a "false-negative" — a test result that incorrectly indicates you don't have prostate cancer when you do.
Because of the complexity of these relating factors, it's important that a physician experienced in interpreting PSA levels evaluates your situation. You want to avoid unnecessary follow-up testing and treatment, but you want to be aware of false-negatives, so don't ignore warning signs.
What's the advantage of a PSA test?
Detecting certain types of prostate cancer early can be critical. Elevated PSA results may reveal prostate cancer that's likely to spread to other parts of your body (metastasize), or they may reveal a quick-growing cancer that's likely to cause other problems. Early treatment can help catch the cancer before it becomes life-threatening or causes serious symptoms. In some cases, identifying cancer early means you will need less aggressive treatment, reducing your risk of side effects such as erectile dysfunction and incontinence. If you are in a group of men at high risk of prostate cancer, you're even more likely to benefit from PSA tests.
What's risky about a PSA test?
You may wonder how getting a test for prostate cancer could have a downside. After all, there's little risk involved in the test itself — it requires simply drawing blood for evaluation in a lab. However, there are some potential dangers once the results are in. These include:
- Worry about false-positive results caused by elevated PSA levels from something other than prostate cancer.
- Invasive, stressful, expensive or time-consuming follow-up tests.
- False reassurance from a PSA test that doesn't reveal cancer (false-negative), leading to a missed diagnosis of aggressive prostate cancer that needs treatment.
- Stress or anxiety caused by knowing you have a slow-growing prostate cancer that doesn't need treatment.
- Deciding to have surgery, radiation or other treatments that cause side effects that are more harmful than untreated cancer.
(1 of 2)
