How do you screen for Prostate Cancer?

Prostate cancer is one of the most common types of cancer and as many as 1 in 8 men will be diagnosed with it in their lifetimes.  Identifying prostate cancer early is key to successful treatment.  In the early stages, prostate cancer often causes no symptoms so routine screenings are important.  There are two acceptable types of routine screenings in the United States, the Digital Rectal Examination (DRE) and the Prostate-Specific Antigen (PSA) blood test.

What is the most accurate test for Prostate Cancer?

Prostate cancer has been known about for over 200 years but up until about 50 years ago, the diagnosis could only be made by Digital Rectal Examination (DRE). DRE is a fairly simple medical procedure. The patient is placed in position, either lying on his side, squatting, bent over, or lying down with feet in stirrups. Then the physician inserts a lubricated finger into the rectum through the anus to check for any abnormalities.

Post-DRE, some patients experience discomfort and/or pain during and even after the procedure. Light bleeding may occur, which can be exacerbated if the patient is also suffering from anal fissures, and/or hemorrhoids. In very rare cases, infection from the procedure can happen as well. ‘Normal’ results of a DRE would mean your physician didn’t find anything abnormal during the exam, however, he or she may recommend additional tests to confirm the results.

The United States Preventive Services Task Force thought the DRE was the most reliable screening test for prostate cancer, until May 2018. The Prostate-Specific Antigen (PSA) blood test has become the gold standard in the healthcare industry for prostate cancer screening and prevention.

In the 1960s and 1970s, many scientists were looking for tumor-specific antigens that may be useful as biomarkers for certain types of cancer. By 1979, T. Ming Chu, Ming Wang, and their research group at Roswell Park Memorial Institute in New York developed the ELISA immunoassay that became useful for blood testing, specifically, the PSA blood test. Thanks to their research and up until the early 1990s, the PSA blood test has become clinically useful for monitoring the course of patients already known to have prostate cancer. In 1994, the Food and Drug Administration (FDA) approved the use of the PSA blood test for first-line screening for prostate cancer.

According to the American Cancer Society (ACS), the PSA is a protein made by cells in the prostate gland (both normal cells and cancer cells). PSA is mostly in semen, but a small amount is also found in the blood. The PSA level in blood is measured in units called nanograms per milliliter (ng/mL). The chance of having prostate cancer goes up as the PSA level goes up, but, according to the ACS, there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer. In fact most men’s (without prostate cancer) PSA levels are under 4 ng/mL. When prostate cancer develops, the PSA may increase. If your PSA level is high, you might need further testing to look for prostate cancer.

Getting a baseline number is important in most cases. Some men get their first PSA test and may want to have regular tests every few years. This method is a good way to spot any changes in your PSA level that might suggest prostate cancer.

It is very important to discuss test results with your physician who understands what the results would mean to you.

PSA vs DRE: Which is more accurate?

The British Journal of General Practices announced recently that DRE is no longer a useful screening test for prostate cancer, as it doesn’t improve a physician’s ability to diagnose the disease.

Meanwhile, the American Cancer Association states the DRE is less effective than the PSA blood test in finding prostate cancer, but it can sometimes find cancers in men with normal PSA levels.  There is also the consideration that a blood draw is less invasive than the physical exam and therefore many people are more likely to take a blood test.  This contributes to a greater likelihood of identifying cancer cases early when there is a greater chance of effective treatment. No screening method is 100% accurate and it is always recommended that one speak to their physician to determine which option is best.

Where can I get a PSA Test near me?

Request A Test provides a quick hassle-free way to order your own PSA blood test.  Just order the test online or by phone and go to one of the over 4,000 labs that we work with across the USA.  Preventative screening is important for diagnosing cancer early.  With Request A Test, you are empowered to take charge of your health.  In addition to the PSA, we offer a full selection of cancer screening blood tests and hundreds of other testing options.  Don't wait.  Place an order or contact us at 888-732-2348 today to get started.

Sources:

• [The long journey from palpation to biopsy : The history of diagnosing prostate cancer] - PubMed (nih.gov)
• Screening for prostate cancer: History, evidence, controversies and future perspectives toward individualized screening - PubMed (nih.gov)
• Medscape Registration
• Digital Rectal Exam (DRE): What To Expect (clevelandclinic.org)
• History of the discovery and clinical translation of prostate-specific antigen - PMC (nih.gov)

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