If you’ve had a positive PSA test and you’re considering a prostate biopsy, or if you’re unsure whether to have regular tests, here are some facts to help you decide.
For any type of screening to be useful, it needs to be effective and the benefits need to outweigh the potential drawbacks. Prostate cancer screening can help to detect cancer early, before you have any symptoms. The test to screen for prostate cancer checks for the amount of a substance in your bloodstream, called prostate specific antigen (PSA).
Regular PSA testing is controversial because it can be inaccurate. Only 1 man in 3 with a high reading has prostate cancer. Infection, recent sexual activity, difficulty with urinating, or having an enlarged prostate (without cancer) can give a high reading. Doctors also disagree about what a ‘normal’ level of PSA is.
A high PSA reading is a sign you could possibly have prostate cancer but it can’t tell you whether your cancer is very slow growing (and unlikely to cause harm), or whether it’s likely to spread rapidly to other parts of your body.
According to the Prostate Cancer Foundation, many cancers detected as a result of a PSA test would never become a problem. These are commonly referred to as over-diagnosed cancers. PSA testing is believed to over-diagnose prostate cancer by 20% to 40%.
The Foundation no longer recommends digital rectal examination for men without symptoms.
What if I’m at high risk?
If you have a family history of prostate cancer, or if the gene for breast cancer is carried in your family, you may be at higher risk. You should discuss this with your doctor.