When Should I Get a PSA?

Prostate cancer is one of the most common cancers worldwide and in the United States. About 1,600,000 men worldwide, and 165,00 men in the United States, are affected by prostate cancer each year. (1,2) Typically, a blood called a PSA, or Prostate Specific Antigen, is used to screen for prostate cancer. The chances of being affected by prostate cancer increases as men get older. Therefore, it is important to know the right time to be screened for prostate cancer. With this in mind, the timing of prostate cancer screening depends of whether a man is considered an average or high risk for this disease. Let’s find out more about the when one should be screened for prostate cancer.

The timing of screening for prostate cancer in average risk men is partly based on when doctors expect to find this disease in a man’s lifetime. Prostate cancer is rarely found before the age of 40 years, and In the United States, over 90% of new cases of prostate cancer are found in men ages 55 years and older. Partly for this reason, the United States Preventative Services Tasks Force (USPSTF) recommends that men ages 55 to 69 have a discussion with their doctor to determine if a prostate screening with a PSA blood test is the right choice. Interestingly, over 60% of the deaths from prostate cancer are seen in men over the age of 75 year. (3) It is though that there is about a 5-year lag time from when PSA levels rise and when prostate cancer is diagnosed. (4) Fortunately, when found early, the 5-year survival rate for prostate cancer is 100%. (3) This is amazing news and continues to highlight the importance of early disease detection.

It is important to identify those who are at higher risk for prostate cancer as these men will need to discuss the benefits of PSA blood testing, and other methods, at an earlier age with their doctor. Men who are carriers, or thought to be carriers, of the breast cancer (BRCA) gene are at a higher risk of prostate cancer and should be tested at an earlier age. African American men and those with have a first degree relative, such as a father or brother, diagnosed with prostate cancer before the age of 65 will should also consider testing for prostate cancer at an earlier age. For these all these high-risk men, discussions of prostate cancer screening should begin at the age of 40 (5,6)

In summary, the 5-year survival for prostate cancer approaches 100% when found early. Also, over 90% of all prostate cancers are found in men over the age of 55. Therefore, it is important to know when you should be tested. For those who are considered average risk, it is suggested that a discussion should take place at or after the age of 55 to determine if a PSA blood test is the right choice. For African American men, carriers of the breast cancer (BRCA) gene or those with a father or brother with prostate cancer before the age of 65 should have this discussion at a younger, specifically at or after the age of 40. In things, make sure to pray for guidance and understanding about this disease. Know your risks and become empowered to make choice that led to better health.

REFERENCES
1. Global Burden of Disease Cancer Collaboration; Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2017 Apr 1;3(4):524-548.
2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018 Jan;68(1):7-30.
3. National Institute of Health. Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Prostate Cancer Available at: https://seer.cancer.gov/statfacts/html/prost.html (Accessed on September 19, 2021)
4. Gann PH, Hennekens CH, Stampfer MJ. A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer. JAMA. 1995 Jan 25;273(4):289-94.
5. Wolf, Andrew MD, et al. “American Cancer Society guideline for the early detection of prostate cancer: update 2010.” CA: a cancer journal for clinicians2 (2010): 70-98.
6. Carter, H. Ballentine, et al. “Early detection of prostate cancer: AUA Guideline.” The Journal of urology2 (2013): 419-426.